| NPI | 1811107998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROBERT PRINCE Owner 630-469-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019-014235) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2009-01-08 |