| NPI | 1508994567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A COGLIANESE President 708-448-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |