| NPI | 1528081965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE T. BOGACKI Owner 773-777-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022471) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2020-08-22 |