| NPI | 1679340459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE A KNABE General Dentist/Practice Owner 815-494-8990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-12 |