| NPI | 1023032604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO D MORTON Vice President 847-299-1095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 060-000979) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |