| NPI | 1982823316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FREDERICK DAVIS President 847-692-2701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060-002798) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |