| NPI | 1174633275 |
|---|---|
| Other Name | EDGEBROOK PERIODONTICS & IMPLANTOLOGY |
| Entity Type | Organization |
| Authorized Contact | JUN SUP LIM President 773-794-1299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 019-023477) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021-001735) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |