| NPI | 1255541884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C. D. WATSON President 773-768-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020850) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |