NPI | 1215166327 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY R MARTIN Owner 773-871-4964 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026201) |
Enumeration Date | 2009-07-09 |
Last Update Date | 2009-07-09 |