| NPI | 1689908535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSMAR RODRIGUEZ President/Dentist 847-531-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001216) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: IL 021001216) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |