| NPI | 1639291875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN SCHEIVE Oral Surgeon D.D.S. 815-727-7748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 19015979) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |