| NPI | 1730478470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY E DARR Company President 618-692-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025281) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-05-05 |