| NPI | 1194942110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ALAN LEHMAN President 815-459-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 060-006476) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |