| NPI | 1326115981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERTA M SILVA President 708-222-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 1223P0300X Dentist, Periodontics | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2020-08-22 |