| NPI | 1558768879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY J HALIHAN Dentist/Owner 815-444-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024027) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |