| NPI | 1346466356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARITA L WOODSON Dentist 708-660-9113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019023319) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2008-07-15 |