| NPI | 1801959937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONORE WOODSIDE President 847-329-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020800) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2017-10-19 |