| NPI | 1538203989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J COOPER Owner 312-666-5166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024658) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2007-09-07 |