| NPI | 1396319711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CORY STITES Insurance COO Rdinator Decision One 630-869-5857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2021-05-19 |