| NPI | 1356588941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY AARON EISSENS President 630-906-9520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-026384) |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-01-19 |