| NPI | 1295909240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES LAUCK President 630-833-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019013525) |
| Enumeration Date | 2008-04-19 |
| Last Update Date | 2008-04-24 |