NPI | 1174570048 |
---|---|
Entity Type | Organization |
Authorized Contact | ALAN MERLIN POLSE President 847-888-8108 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 1915649) |
Enumeration Date | 2006-05-27 |
Last Update Date | 2007-08-02 |