| NPI | 1598746364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE DOMINICK DITOLA Business Owner 708-865-1214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019016202G) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2008-06-16 |