| NPI | 1538386933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN NABONG ABIERA President 815-395-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024176) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-09-27 |