| NPI | 1194130013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARIDEH NIKOO DAFTARY Owner/Dentist 312-922-1898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019025332) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |