| NPI | 1245634534 |
|---|---|
| Doing Business As | MAYWOOD FAMILY DENTAL LTD |
| Entity Type | Organization |
| Authorized Contact | JAMES POULOS President 708-865-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 019.016695) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |