| NPI | 1770988594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MILES SNYDER Managing Member 618-581-9201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: IL 021002548) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |