| NPI | 1255544912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK MICHAEL GORMAN Co Owner Partner 708-331-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019A12318) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019014567) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |