| NPI | 1881966042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY J ROEDER Doctor/Owner 309-762-1602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19023696) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |