| NPI | 1295560712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE D. LICHTENSTEIN Owner 847-927-0283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-09-04 |
| Last Update Date | 2024-10-24 |