| NPI | 1831244045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN J TILDEN Owner 312-664-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19A14168) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |