| NPI | 1578140794 |
|---|---|
| Doing Business As | BLOOMINGDALE DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | KEVIN FATLAND Manager 708-990-7869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-04-14 |