| NPI | 1033496112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NERITA STRACHAN Receptionist 847-947-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2011-11-03 |
| Last Update Date | 2014-09-17 |