| NPI | 1982186896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDAN D MCGRAW Owner 815-485-3449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019029805) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |