| NPI | 1134537889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE FISHER President 847-882-2555 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019023892) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2014-07-25 |