| NPI | 1124417282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE Y, ZIMMERMANN President 847-729-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 122300000X Dentist |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality | |
| 1223G0001X Dentist, General Practice | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-20 |