| NPI | 1417559675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SAGUN Orthodontist 847-668-7316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-11-12 |