| NPI | 1427375278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOSEPH RYAN President 708-532-4121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 0190193333) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: IL 1811932106) |
| 261QD0000X Clinic/Center Dental (Licence: IL 1891985552) | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2010-05-03 |