| NPI | 1104310150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY S MCBETH President 630-668-6071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019025533) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2018-06-21 |