NPI | 1710102967 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL SENDERAK Owner 815-758-4431 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019844) |
Enumeration Date | 2007-04-14 |
Last Update Date | 2020-08-22 |