NPI | 1376915348 |
---|---|
Entity Type | Organization |
Authorized Contact | KHANH NGUYEN Owner 773-284-5510 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026820) |
Enumeration Date | 2015-10-29 |
Last Update Date | 2015-10-29 |