| NPI | 1376919258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK G DAWSON President/CEO 312-953-8708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022252) |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2015-08-14 |