| NPI | 1922156686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BURTON S TUREK Secy 847-392-5842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |