| NPI | 1538330758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVANA BUENO Director Of Corporate Operations 773-798-9382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2008-03-15 |
| Last Update Date | 2025-10-13 |