| NPI | 1164843421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN WILLIAM CULLINAN General Dentist 847-998-1281 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: 019027128) |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2015-06-04 |