| NPI | 1245415256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERIN B JACOB President 708-652-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025452) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |