| NPI | 1003088006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA MARTINEZ Dentist 773-522-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019027035) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2010-07-20 |