| NPI | 1346570421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY AIVAZIAN Dentist 847-228-5523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019768) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |