| NPI | 1689939969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JAMES ALLEN President 312-340-5761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.027497) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |