| NPI | 1528454030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN VILLANUEVA Practice Manager 630-324-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019029734) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2015-04-10 |