| NPI | 1730361791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA MARIE WESTFALLEN President 847-823-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-12-02 |
| Last Update Date | 2007-12-02 |