| NPI | 1386168953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK MICHAEL MITSOS President 708-429-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019029811) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-08-24 |