| NPI | 1336668359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE LILY GULIANA Owner 773-527-9141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019031094) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |