| NPI | 1366512022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MADDALOZZO President 847-934-4280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-021223) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021-001510) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |