| NPI | 1104467281 |
|---|---|
| Doing Business As | DENTAL RECONSTRUCTION CENTER |
| Entity Type | Organization |
| Authorized Contact | CARL A-M LEONARD Owner 847-673-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-09-30 |