| NPI | 1740427954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL HAYWARD GERTSCH President 708-748-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-015925) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-01-09 |