| NPI | 1447816616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIANJUN HAO Owner 773-941-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |