| NPI | 1851393995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS CHARLES SHINDOLLAR President 815-254-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL IL019019493) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2014-12-08 |