| NPI | 1134437262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC G. JACKSON Owner 630-963-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026703) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |