NPI | 1578153151 |
---|---|
Entity Type | Organization |
Authorized Contact | MONIKA BZDAL Director Of Support Services 815-340-1046 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2021-01-19 |
Last Update Date | 2021-01-19 |