| NPI | 1699947721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH KENNETH ERDMANN President 708-795-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019017907) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |