| NPI | 1194301473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANU SOOD President 312-451-4106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-05-06 |