| NPI | 1447542774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KISHORE GOPAL Dentist/Owner 224-678-3511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019023845) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |