NPI | 1932390200 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSEPH MICHAEL POPE President 309-688-7007 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-017658) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2007-08-05 |