| NPI | 1356668867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKISHA NANDINI JODHAN Periodontist/ President 847-512-7410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |