| NPI | 1790280758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KOEHNE President/Dentist 630-665-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019019448) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |