NPI | 1689737868 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN PAUL THEODOSIS President Dentist 847-253-5800 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: IL 019022523) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2020-08-22 |