| NPI | 1497466890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVANA BUENO Director 773-798-9382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2022-12-07 |