| NPI | 1346387354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY R. REYNOLDS Vice President Secretary 847-392-7947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 19-014144) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |