| NPI | 1699852335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT STEVEN MCGONIGLE Vice President 708-429-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 060001305) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |