| NPI | 1396126546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST OPIOLA President 773-919-9876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 019028296) |
| Enumeration Date | 2015-06-13 |
| Last Update Date | 2015-06-13 |