| NPI | 1154560241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJAN SHARMA Owner 312-915-0535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IL 021-001569) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: IL 021001569) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |