| NPI | 1619220852 |
|---|---|
| Other Name | PRAIRELAND DENTAL |
| Entity Type | Organization |
| Authorized Contact | DON E ABEL President 618-392-7481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 060002438) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2012-10-25 |