| NPI | 1184934440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL KURAL Director Doctor Credentialing 312-274-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: PA DS037832) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2020-03-12 |