| NPI | 1699556787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BAILEY Operations Manager 630-230-1272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2023-10-13 |
| Last Update Date | 2023-10-13 |