| NPI | 1821366915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS R PRINCE Owner 630-995-3547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021-000784) |
| Enumeration Date | 2011-12-05 |
| Last Update Date | 2011-12-05 |