| NPI | 1558826453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY HADLEY Owner, President & Secretary 708-596-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2020-06-26 |