| NPI | 1659619500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN CASIMIR THARP President 815-712-6521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.028356) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-01-28 |