| NPI | 1740329093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY E. BOOTH President 708-301-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |