| NPI | 1760925580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD L WINN President 630-631-2407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE00008000) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |