| NPI | 1578633178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH M LUTSCH Owner 815-877-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-020868) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2020-08-22 |