| NPI | 1841628310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN W LODDING Owner 847-697-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019017360) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2013-10-21 |