| NPI | 1598974651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS P ROONEY President 815-224-1534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2008-03-13 |