| NPI | 1255587481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH WILLIAM GINN Owner 708-444-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018544) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2008-08-07 |