NPI | 1417384793 |
---|---|
Doing Business As | IVORY DENTAL SPECIALIST LLC |
Entity Type | Organization |
Authorized Contact | BONCIEL GRIFFIN Orthodontist/Owner 773-239-7696 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019025726) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002361) |
Enumeration Date | 2013-10-02 |
Last Update Date | 2013-10-02 |