NPI | 1518239268 |
---|---|
Entity Type | Organization |
Authorized Contact | ERIN N DUMSTORFF Office Manager 618-235-9101 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019013509) |
Enumeration Date | 2012-01-27 |
Last Update Date | 2012-01-27 |