| NPI | 1730195496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS J GEORGE, DDS President 312-944-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 060-004380) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |