NPI | 1912074980 |
---|---|
Entity Type | Organization |
Authorized Contact | JEROME VICTOR PISANO President 847-605-8880 |
Organization Subpart ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: IL 021000890) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2020-08-22 |