| NPI | 1548472368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMAN GRAULICH Authorized Official 217-651-4669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: PA DS026193L) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2025-04-21 |