| NPI | 1285123349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM STIRNEMAN Managing Member 847-558-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019022088) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2020-08-26 |