| NPI | 1609046283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN PHUONG NGUYEN Dds 847-729-0008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019025837) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-03-10 |