| NPI | 1205095387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA A SERKLAND Practice Administrator 847-869-9303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 060.001866021.001194) |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2008-06-04 |