| NPI | 1568493591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D DANNER Owner 309-346-2145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-023984) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-05-31 |