| NPI | 1790152197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYS VALCOURT EWA President 708-307-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022941) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |