| NPI | 1497963326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD E CLELAND Dentist 708-349-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-014460) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-04-22 |