| NPI | 1780724641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY ORLANDO PONZIO President 708-452-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026290) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2014-04-29 |