| NPI | 1124257571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BRUNETTI President 847-367-4190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IL 019025890) |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2009-07-07 |