| NPI | 1215337779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUNG SHIN General Dentist 773-940-1967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.029678) |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |