| NPI | 1194890400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A CERONE Dentist 630-627-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019018256) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019019639) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |