| NPI | 1487669156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SATISH REDDY Dentist 773-754-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2025-04-15 |