| NPI | 1457629578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AHMED MATARIA Owner 708-543-0795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027955) |
| Enumeration Date | 2011-12-03 |
| Last Update Date | 2011-12-03 |