NPI | 1245597020 |
---|---|
Doing Business As | MY DENTIST & ASSOCIATES |
Entity Type | Organization |
Authorized Contact | ROSLYN TRAVIS-STRATTON Dentist 773-434-1515 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019021392) |
Enumeration Date | 2012-04-18 |
Last Update Date | 2012-04-18 |