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 |