| NPI | 1619212131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSTAPHA A HOTAIT President 708-849-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019028105) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |