| NPI | 1134228620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A. RODGERS Owner 630-759-4191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-018633) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |