| NPI | 1285144493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE BLASKO Dentist/Partner 630-869-0063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019.026417) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2022-07-21 |