NPI | 1275770596 |
---|---|
Entity Type | Organization |
Authorized Contact | MAZEN MANLA Presedent 312-451-4050 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D 11855) |
Enumeration Date | 2009-01-08 |
Last Update Date | 2009-01-08 |