| NPI | 1659581528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID D JANES President 815-338-7569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-A15666) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |