| NPI | 1487859674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C. DAVID BRICKMAN Orthodontist 1618-462-1081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: IL 19024626) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |