NPI | 1649303892 |
---|---|
Doing Business As | STREETERVILLE DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | SCOTT F. FUTCH Owner 312-337-2212 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025503) |
Enumeration Date | 2007-03-14 |
Last Update Date | 2011-02-16 |