| NPI | 1518296938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD E KRAUSE President 815-937-3521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019018002) |
| Enumeration Date | 2009-12-14 |
| Last Update Date | 2009-12-14 |