| NPI | 1760657548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONSTANTIN JOHN KOHAN Dentist 847-255-3227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025684) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |