| NPI | 1154674471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAROSLAV YARMOLYUK Owner 847-749-4340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021.002488) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2023-08-21 |