| NPI | 1578680765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA D GRUENDEMAN President 630-368-0605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021601479) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2015-11-10 |