| NPI | 1851639835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES D MARTINEZ Dentist/Owner 847-214-1324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022943) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |