| NPI | 1114090750 |
|---|---|
| Other Name | OMDENT |
| Entity Type | Organization |
| Authorized Contact | KRYSTYNA WAGENEHJM-CIESIELSKI President 847-581-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019024460) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 021002182) |
| 1223P0300X Dentist, Periodontics (Licence: IL 021001519) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2008-07-03 |