| NPI | 1346645637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ANTHONY HECKENBACH Dentist 847-254-2109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA DS040091) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2014-10-29 |