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 |