| NPI | 1467615716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNARD E RYAN President 815-932-9695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019015907) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2008-07-08 |