NPI | 1497027015 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY CHANG Member 773-267-8600 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025589) |
Enumeration Date | 2012-01-27 |
Last Update Date | 2014-10-01 |