NPI | 1346486289 |
---|---|
Entity Type | Organization |
Authorized Contact | TIMOTHY B DOTSON Dentist/Partner 773-528-3384 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020240) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019025986) |
Enumeration Date | 2008-12-24 |
Last Update Date | 2008-12-24 |