| NPI | 1659541282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE RENE' MONTEITH Dentist/Owner 847-998-8990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-024425) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-11 |