| NPI | 1104260884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELA DURAES President 708-834-3602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019028921) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-04-24 |