| NPI | 1063550952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK J INCARDONA President Treasurer 847-392-7947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 319-009592) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |