| NPI | 1396917993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO MORTON Vice President 847-885-1095 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 060000979) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2008-03-24 |