| NPI | 1124573639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS V BORDIGNON General Dentist 847-724-2160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019-02251) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |