| NPI | 1508932609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CHARLES WRIGHT Partner 847-381-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.017473) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.017300) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2012-02-09 |