| NPI | 1710162326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA M RENKEN Owner 217-483-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025823) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2019-08-28 |