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