| NPI | 1770010100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN DAVID WILLIAMSON Dentist/Owner 618-281-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027747) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2021-12-21 |