| NPI | 1568910784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GOLDBERG Owner 218-209-8027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019029576) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |