NPI | 1821491937 |
---|---|
Other Name | DBA PREMIER ENDODONTIC ASSOCIATES |
Entity Type | Organization |
Authorized Contact | BRIAN WARDELL Manager 630-655-3636 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021002266) |
Enumeration Date | 2014-10-02 |
Last Update Date | 2020-10-30 |