| NPI | 1629218557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A. MELISSA LOPEZ Co Owner 847-446-0950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019025964) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2012-08-16 |