| NPI | 1053587717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH L. BEATY Dentist 312-332-4424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060006022) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |