| NPI | 1184288151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMED RAMAHA Owner 708-394-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-08-09 |