| NPI | 1003938721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L AHASIC President 630-897-1156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019015986) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |