| NPI | 1326062951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK A MAGGIO President 847-697-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: IL 21000876) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-22 |