| NPI | 1568634848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT DICK JAMES President 618-667-3446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025675) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-03-27 |