| NPI | 1548889496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY SMITH Orthodontist 847-833-1272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2024-09-17 |