| NPI | 1588055560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA GRANNAN Dentist 630-834-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.023318) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |