| NPI | 1568671816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | H. EDWARD VALLELY CEO 847-392-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 01915568) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |