| NPI | 1598063885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALLEN BERQUIST Owner/Dentist 708-799-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19-011929) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |