| NPI | 1417128026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHTHA VINIAK General Dentist 773-704-1974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027356) |
| Enumeration Date | 2008-03-23 |
| Last Update Date | 2008-03-23 |