| NPI | 1356764682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT GOLDMAN President 773-237-8778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021002316) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |