| NPI | 1588818736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A HOSKINS Receptionist 309-682-5863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021-000885) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2008-11-13 |