| NPI | 1851897268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEREDITH ANN GANTOS Owner/Dentist 630-420-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-029792) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |