| NPI | 1982197984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY WOLTER Insurance Manager 630-869-5857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019021569) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2018-06-13 |