| NPI | 1013248293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JAMES PROSNIEWSKI President 708-456-6882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018332) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2010-01-27 |