| NPI | 1841579612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN LEAKE Owner/Dentist 708-927-5111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027730) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2011-08-11 |