| NPI | 1700942513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESTER W HENSELMAN Dentist 847-272-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-014214) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2012-02-07 |