NPI | 1932543287 |
---|---|
Entity Type | Organization |
Authorized Contact | SCOTT GOLDMAN President 847-987-0322 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019027333) |
Enumeration Date | 2013-04-17 |
Last Update Date | 2013-04-17 |