| NPI | 1306859814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN PESAVENTO Dentist/Orthodontist 630-896-7739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 01914382) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |