| NPI | 1114046398 |
|---|---|
| Former Legal Business Name | M.E. BRUNDAGE, DDS & W. C. WISE DDS, LTD |
| Entity Type | Organization |
| Authorized Contact | MICKIE KERR Office Manager 708-524-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019013316) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2017-05-10 |