| NPI | 1720465099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY C. LAMB Clinical Associate Professor 312-413-2836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019019207) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |