| NPI | 1154452852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN BAUER President 312-371-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026380) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2012-05-24 |