| NPI | 1528373180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURA J VROMAN Owner/Orthodontist 309-797-0106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019028210) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: IA 08686) |
| Enumeration Date | 2010-08-07 |
| Last Update Date | 2010-08-07 |