| NPI | 1639677040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY JOHN CASTILLO SAGADRACA Owner 630-260-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019030727) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2018-01-31 |