| NPI | 1225660046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMAD MILLWALA Owner 773-732-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-02-10 |