| NPI | 1073750402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN E. MAZZOTTI Dentist/Owner 708-798-4424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.021636) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2009-01-07 |