| NPI | 1972878197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD C. KELLNER Owner/Dentist 630-859-3151 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019017632) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019028094) |
| 122300000X Dentist (Licence: IL 019024905) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-03-21 |