| NPI | 1821185562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY M NATHANSON President 847-394-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 060001855) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |