| NPI | 1437671799 | 
|---|---|
| Doing Business As | DESTINY DENTAL | 
| Entity Type | Organization | 
| Authorized Contact | BORIS LABINOV Agent 708-613-4542  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2017-07-08 | 
| Last Update Date | 2017-07-08 |