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 |