| NPI | 1295065548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIBTAIN KERAI President 815-556-8126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-026667) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN 16907) |
| Enumeration Date | 2010-01-09 |
| Last Update Date | 2010-01-09 |