| NPI | 1215109160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOWELL EDWARD BLECHA President 630-961-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 021001045) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |