| NPI | 1578628269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KIM President 815-633-7933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022947) |
| Enumeration Date | 2006-12-25 |
| Last Update Date | 2008-04-17 |