| NPI | 1427572247 |
|---|---|
| Doing Business As | WELLSPRING PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | ANKUR PATEL Periodontist 312-834-3368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-08-02 |