| NPI | 1205992617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY E. ZOLLINGER President 708-596-6181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 19A15529) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2008-04-24 |