| NPI | 1942717228 |
|---|---|
| Doing Business As | RESTORATION DENTAL |
| Entity Type | Organization |
| Authorized Contact | KYE EDWARD MALLERNEE Dentist 217-619-1059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31328) |
| Enumeration Date | 2018-01-08 |
| Last Update Date | 2018-01-08 |