| NPI | 1689735458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENZO NICASTRO Owner 815-464-7587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |