NPI | 1447455175 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON F BROWN Co Owner 630-810-1199 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-025403) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-019321) |
Enumeration Date | 2007-06-21 |
Last Update Date | 2020-08-22 |