| NPI | 1104441005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KUNNEL Partner 312-317-5647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-16 |