| NPI | 1861647588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN ALAN BRAVERMAN President/Owner 847-433-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IL 019023544) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2008-11-21 |