| NPI | 1356560395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP COLE President 708-429-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060-004578) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |