| NPI | 1558662106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHESTER PAUL KLOS President 773-622-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.017535) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.027916) |
| Enumeration Date | 2010-11-13 |
| Last Update Date | 2015-04-01 |