| NPI | 1265979553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAFA GHAZI ALSAFI Dentist 312-576-3948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TX 31067) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |