| NPI | 1366788697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID KODNER President 773-622-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 01908827) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |