| NPI | 1295192078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA BZDAL Insurance Coordinator 773-801-7171 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002488) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2020-01-21 |