| NPI | 1902042534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JOHN DENEMARK President/Owner 630-654-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 0109022926) |
| Enumeration Date | 2009-01-03 |
| Last Update Date | 2010-11-29 |