NPI | 1154598902 |
---|---|
Entity Type | Organization |
Authorized Contact | GEORGE E MORRIS Owner 708-798-4730 |
Organization Subpart ? | No |
Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019019289) |
Enumeration Date | 2008-05-12 |
Last Update Date | 2016-04-18 |