NPI | 1689735458 |
---|---|
Entity Type | Organization |
Authorized Contact | VINCENZO NICASTRO Owner 815-464-7587 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019023896) |
Additional Taxonomies | 122300000X Dentist (Licence: IL 019027025) |
Enumeration Date | 2006-12-13 |
Last Update Date | 2020-08-22 |