| NPI | 1881765626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ALBERT HOLZ President 847-680-0125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060004294) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |