| NPI | 1417223470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DIMOULIS Owner 773-769-1754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021001402) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 021002414) |
| 1223E0200X Dentist, Endodontics (Licence: IL 021002411) | |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |