| NPI | 1467540518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE KOWALSKI Office Manager 773-233-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 200504479) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |