| NPI | 1811062557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY K. DUNN President/Owner 618-283-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060003846) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2016-12-14 |