| NPI | 1043597305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT D GOLDMAN Owner 312-310-4543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019027333) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2013-06-17 |