| NPI | 1184989584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD T BAKER Managing Partner 773-783-8326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019025166) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |