| NPI | 1144743709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD HAWASLI Periodontist 773-629-0329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VA 0401414973) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-08-04 |