| NPI | 1154573558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S ZELLER Dentist 773-779-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060.008435) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |