NPI | 1528889292 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXIS POLCZYNSKI Owner/Doctor 618-920-3473 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2024-10-24 |
Last Update Date | 2024-10-24 |