| NPI | 1306188305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY SELLKE President 847-249-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021000786) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-03-18 |