| NPI | 1487866919 |
|---|---|
| Doing Business As | WILLOW KNOLLS FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | AMY KROEGER Ins COO D 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2008-05-21 |