NPI | 1851529382 |
---|---|
Doing Business As | DISTINCTIVE DENTISTRY |
Entity Type | Organization |
Authorized Contact | CONRAD MAGNO President 312-545-8671 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.026625) |
Enumeration Date | 2009-06-23 |
Last Update Date | 2009-06-23 |