NPI | 1679761969 |
---|---|
Entity Type | Organization |
Authorized Contact | SHEILA M DALY Office Manager 708-448-8670 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2007-10-11 |
Last Update Date | 2007-10-11 |