NPI | 1669706800 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD D LOPEZ President 708-386-3200 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027665) |
Enumeration Date | 2009-09-21 |
Last Update Date | 2013-12-03 |