| NPI | 1508188244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPIROS J LAFAZANOS CEO 815-455-5490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019023307) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |