| NPI | 1598830325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A SMULSON President 847-251-0077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021001200) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |