| NPI | 1275843799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS GULLERMO LOPERA General Dentist 847-672-4201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019026862) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |