| NPI | 1982853636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY OWEN KRAUSS Owner/Dentist 217-271-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009127) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2008-09-17 |