| NPI | 1881182103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL SKURIE Owner 847-432-0254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2021-06-07 |