| NPI | 1437355013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN P MORIMOTO President 815-741-0095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021001077) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2008-01-03 |