| NPI | 1912070228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN MINTZ President 708-755-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021001405) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |