| NPI | 1609016351 |
|---|---|
| Doing Business As | WICKER PARK ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | NIDZA ALICEA Manager 773-235-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: IL 060010055) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2009-02-20 |