| NPI | 1598543027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNEY SIMPSON Owner 312-888-6208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |