| NPI | 1407028624 |
|---|---|
| Other Name | SUBURBAN DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | RICHARD MAZANEK Owner 847-823-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018548) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019018545) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2010-01-12 |