NPI | 1114144060 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN J SHANDLEY President 847-428-4646 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060007536) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2023-09-20 |