NPI | 1275352049 |
---|---|
Doing Business As | EBELING FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | LAURA M MARTINEZ AVERSANO President 847-910-2873 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-10-08 |
Last Update Date | 2024-10-30 |