| NPI | 1578752044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL R A NICOTRA Pres 847-358-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 01913082) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |