NPI | 1215335567 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN MICHAEL BAKER Dentist 630-968-3381 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 19A15345) |
Enumeration Date | 2014-12-18 |
Last Update Date | 2014-12-18 |