NPI | 1285788133 |
---|---|
Entity Type | Organization |
Authorized Contact | LARISA FELDMAN President 847-638-6060 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-025103) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2012-03-07 |