| NPI | 1144456658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS TSALIAGOS Owner 1312-666-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19023116) |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |