NPI | 1619144524 |
---|---|
Entity Type | Organization |
Authorized Contact | DENISE R FLYNN Owner 309-346-5140 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001854) |
Enumeration Date | 2008-05-09 |
Last Update Date | 2008-05-09 |