| NPI | 1821253931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS BECKER Owner 847-622-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025213) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2008-07-29 |