| NPI | 1659560464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN D MCMAHON President 847-823-5142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 01911351) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2008-01-16 |