| NPI | 1528253994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD A. STEPHEY CEO 309-662-7722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019017386) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |