| NPI | 1497083034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKEN ICHKHAN Dds/Owner 847-414-3573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: IL 060010238) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |