| NPI | 1568886398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMPLE TEJANI Dentist 847-255-3815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019025474) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2021-01-28 |