| NPI | 1962717314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTTO JAMES TOR President 708-614-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19014420) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |