| NPI | 1003986373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT Q MARSHALL Dentist 708-532-8889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL IL019020333) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |