| NPI | 1740377480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J RYAN President 847-506-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 215965) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 19A15156) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2012-12-05 |