| NPI | 1972796654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN R. SCHOENHEIDER Owner 708-636-0786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018217) |
| Enumeration Date | 2007-08-25 |
| Last Update Date | 2007-08-25 |