| NPI | 1770646143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C KEMP President 847-255-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 060007780) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |