| NPI | 1164790200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA YUJIN LEE Co President 847-650-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-026114) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-028193) |
| Enumeration Date | 2011-12-04 |
| Last Update Date | 2011-12-04 |