| NPI | 1346663739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTON ZHADOVICH Director 847-687-1158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019029511) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |