| NPI | 1487103354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MITCHELL DROZDZ President 224-628-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019-018712) |
| Enumeration Date | 2016-10-03 |
| Last Update Date | 2016-10-03 |