| NPI | 1265508949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LAWRENCE DISCIPIO President Owner 708-749-0133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19A-10123) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 19A19017) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |