| NPI | 1275670283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY R REYNOLDS Vice President Secretary 847-392-7947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 19-014144) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |