| NPI | 1063786838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BECKER Manager 708-532-4363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020163) |
| Enumeration Date | 2012-02-26 |
| Last Update Date | 2012-02-26 |