| NPI | 1578886214 |
|---|---|
| Doing Business As | BRIDGEPORT FAMILY DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | STEVEN VONGLUEKIAT Owner 312-791-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027344) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019027363) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-03-09 |