| NPI | 1477567386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY ALAN BLANEY Dentist 773-221-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-020325) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |