| NPI | 1508935305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN D AN President 847-458-6684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025478) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2014-05-21 |