| NPI | 1295805034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J LEHENBAUER Dentist 708-485-0340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019020923) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019021033) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |