| NPI | 1972646925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG R HORNYAK General Dentist Managing Member 815-477-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019023055) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2020-08-22 |