| NPI | 1093089690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE MULVANEY Sole Member 847-423-2488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020600) |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2012-02-28 |