| NPI | 1053618462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL I SONG Dr/Owner 847-259-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.024518) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2011-02-21 |