| NPI | 1992713861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C DAVID BRICKMAN President 618-656-3837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001903) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2016-10-10 |