| NPI | 1770729253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL D. KENDRICK Managing Member 217-525-6872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019016476) |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2009-01-05 |