| NPI | 1881895738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN W. KLOHR Dentist 618-281-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026475) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |