NPI | 1508033291 |
---|---|
Entity Type | Organization |
Authorized Contact | A MELISSA LOPEZ President 773-758-2010 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019025964) |
Enumeration Date | 2008-05-12 |
Last Update Date | 2012-08-16 |