| NPI | 1366500159 |
|---|---|
| Other Name | CORPORATION |
| Entity Type | Organization |
| Authorized Contact | DONALD CHRISTIE BEARD President 630-530-4808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 060005577) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-08-22 |