| NPI | 1316167174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENZO NICASTRO President 815-464-7537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019023896) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |