| NPI | 1073822490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK S. LITZ President 773-735-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IN 01912745) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |