| NPI | 1811387764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA STIFTER Dentist 708-361-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019019229) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |