| NPI | 1134143977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD SEGAL President 847-498-5630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 060008487) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2015-05-12 |