| 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 |