| NPI | 1710306972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELICA VAN DYKE Dentist 630-579-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019.027362) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |