| NPI | 1134370059 |
|---|---|
| Former Legal Business Name | MEFAGUI DENTAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | ELSA GAMBOA President 773-622-4006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022954) |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2008-10-09 |