| NPI | 1669778601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK D SATROM President 618-624-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 060.009554) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2011-02-09 |