| NPI | 1013058460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY B RUZ President 773-743-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019022783) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019022956) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |