| NPI | 1316074818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIDA TICZON PREZA President 773-769-8195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022955) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2012-04-15 |