| NPI | 1841302155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY LEE Managing Partner 815-725-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-017638) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |