| NPI | 1932372547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE ANTHONY GORDON Business Development 630-926-5193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024669) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2008-04-04 |