| NPI | 1205084456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD REZA EKHTERA President 847-920-0320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 31901441) |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2008-08-29 |