NPI | 1982822912 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MICHAEL SISTO President 847-696-4848 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: IL 019 016656) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2020-08-22 |