| NPI | 1326457169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHA M NGUYEN Managing Member 708-957-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019028743) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |