NPI | 1831464585 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD S. CONEN President 847-372-3327 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-020803) |
Enumeration Date | 2012-03-14 |
Last Update Date | 2012-03-14 |