| NPI | 1508035619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA S PRESCOTT Owner 773-544-1025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 019-026763) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2008-02-22 |