NPI | 1851556179 |
---|---|
Entity Type | Organization |
Authorized Contact | HARVEY H BRECKNER Dentist 618-206-2396 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: IL 19020061) |
Enumeration Date | 2008-07-25 |
Last Update Date | 2008-07-25 |