NPI | 1760601298 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL VOLD Owner 847-272-2900 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019013223) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2020-08-22 |