NPI | 1245678473 |
---|---|
Entity Type | Organization |
Authorized Contact | MILTON L DAVENPORT President 312-291-9571 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021002223) |
Enumeration Date | 2013-06-10 |
Last Update Date | 2013-07-10 |