NPI | 1487956959 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS J STREITZ Owner 815-725-6868 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019010971) |
Enumeration Date | 2010-12-03 |
Last Update Date | 2010-12-03 |