| NPI | 1497261648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA BZDAL Manager 773-801-7171 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2019-12-12 |