NPI | 1508269358 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS WILLIAM BRZOSTOWSKI President 630-852-6666 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019021165) |
Additional Taxonomies | 122300000X Dentist (Licence: WI 019025308) |
Enumeration Date | 2014-10-07 |
Last Update Date | 2014-10-07 |