| NPI | 1396235651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHARINE STEVENS Owner 773-382-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002679) |
| Enumeration Date | 2018-05-12 |
| Last Update Date | 2019-01-13 |