| NPI | 1487098075 |
|---|---|
| Other Name | CHARLES STREET DENTAL |
| Entity Type | Organization |
| Authorized Contact | EKRAM K SAEED Dentist 815-399-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019-023618) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2013-04-25 |