NPI | 1801268305 |
---|---|
Entity Type | Organization |
Authorized Contact | JANICE A LUBAS Secretary 708-424-1300 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019020526) |
Enumeration Date | 2015-10-22 |
Last Update Date | 2015-10-23 |