| NPI | 1134299860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE R FINE President 708-383-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060001485) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |