| NPI | 1730197468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KURT E BRUKSCH Vice President 815-459-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019018137) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2010-06-03 |