| NPI | 1477613297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE ALLEN SCHUTTE President 618-628-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021.001638) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2013-08-16 |