Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | IL | |
N | 1223X0400X | Orthodontists | IL |
NPI | 1063599470 |
---|---|
Provider Name | Dr. Karl Frank Muster |
First Address | Danville, IL 61832-3849 |
Second Address | Danville, IL 61832-3849 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |