| NPI | 1891915914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER ERNEST FAITH Owner 630-837-5156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-08-22 |