NPI | 1235283821 |
---|---|
Entity Type | Organization |
Authorized Contact | GREGORY J DUFFNER Dentist 708-798-6868 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019782) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2008-09-23 |