NPI | 1316342041 |
---|---|
Entity Type | Organization |
Authorized Contact | FREDERICK W. MUELLER President 708-448-0333 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019018192) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019028943) |
Enumeration Date | 2014-10-23 |
Last Update Date | 2014-10-23 |