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