| NPI | 1205087285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ANN MONTGOMERY Owner/Dentist 773-239-7258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-022902) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2008-10-08 |