| NPI | 1992126304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIK DUBRAVEC President 815-464-3001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: IL 019021633) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |