| NPI | 1164638557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JAMES SERETIS Owner 847-895-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022443) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019022177) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |