| NPI | 1013022821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DENNIS LANE President 847-392-4270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019012508) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |