| NPI | 1699912386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE D HANSEN President 815-398-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019603) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-01-16 |