| NPI | 1235438177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN DIEHNELT Dentist/Owner 847-818-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-023133) |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2019-03-15 |