| NPI | 1376616607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD J SWANSON Owner 847-884-8876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019018072) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2014-01-27 |