| NPI | 1467059865 |
|---|---|
| Doing Business As | AMERICAN DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | HIDAYATHULLA KHAN President 224-766-9876 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2020-10-08 |