NPI | 1215146741 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES BENNET SWANSON President 708-448-3323 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060-005739) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2020-08-22 |