| NPI | 1942653324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VESNA S SUTTER President/Dentist 224-517-3474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019017117) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019029595) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2019-02-04 |