| NPI | 1114054103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W. BRANDSTATTER President 773-283-0321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060-002984) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |