| NPI | 1700990447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED M FITZPATRICK President 815-459-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL A13595) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-08-22 |