| NPI | 1932373206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK J GRUNBERG Owner/Practitioner 773-276-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019018396) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |