| NPI | 1548743776 |
|---|---|
| Former Legal Business Name | THE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | MADHURIMA DAMERA President 773-344-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |