| NPI | 1861607798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J. PULLARA Owner 815-436-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019021493) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-02-20 |