| NPI | 1942422829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILENNE NOETZEL Doctor Owner 708-755-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19-024975) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |