| NPI | 1073786406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MICHAEL GRIMLEY President 630-369-6980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-018993) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |