| NPI | 1902926330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A. NUDERA Owner 847-760-6353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 60009337) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |