| NPI | 1558494864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE WESLEY BARNETT President 312-726-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019015262) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |