| NPI | 1578684262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER ZENAS BLISS Dentist 630-260-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019017697) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |