| NPI | 1740599547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEANNE PATRICIA THATCHER Owner 309-788-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.024751) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2010-09-28 |