| NPI | 1184990897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY AFZALI President 847-724-3969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-03-27 |