| NPI | 1518380070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS R KRUG Member 309-828-1463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-018709) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |