| NPI | 1700058401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE PATRICK LOOBY Owner 773-844-5666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024661) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |