| NPI | 1629249610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHIL KURAL Director Doctor Credentialing 312-274-4526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024846) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2020-03-17 |