| NPI | 1164202719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGDI IBRAHIM Doctor 708-737-5457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2024-02-27 |