NPI | 1891843637 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES MATTHEW ADAMS President 815-939-7136 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 060002115) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2009-03-31 |