NPI | 1104245950 |
---|---|
Entity Type | Organization |
Authorized Contact | TINA GRANDINETTI Office Manager 312-217-3333 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019024774) |
Enumeration Date | 2014-04-09 |
Last Update Date | 2014-04-09 |