| NPI | 1124287362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA LYNN DIMARIO Sole Proprietor 773-271-6168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024582) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2011-10-20 |