| NPI | 1558984427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VILIJA MCWILLIAMS Office Manager 708-422-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist Dental Public Health |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2025-06-06 |