| NPI | 1568763605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA KOTHAPALLI Associate 630-803-6431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026612) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2010-11-05 |