| NPI | 1104541622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NECHAMA BRAND Partner 312-726-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2022-10-06 |