| NPI | 1003085465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSANNA MIRANDA LESNIAK President 847-955-2331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019025184) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2012-06-06 |