NPI | 1700207594 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN ALVAN GORDON Treasurer 630-878-0351 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020648) |
Enumeration Date | 2013-12-20 |
Last Update Date | 2013-12-23 |