| NPI | 1326349770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN STUART BROWN Office Manager 773-276-5566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019016946) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |