NPI | 1669588778 |
---|---|
Entity Type | Organization |
Authorized Contact | PHYLLIS A. DIXON Dentist/Owner 630-629-8770 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-020640) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2020-08-22 |