| NPI | 1013464593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YESENIA DELGADO General Manager 773-887-3244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-027782) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |