| NPI | 1033363304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LAWLEY President 708-409-0990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 1917431) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2012-12-29 |