| NPI | 1194811885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY ANN JOHNSON President 708-647-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019016821) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-06-17 |