| NPI | 1629444625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OGBONNA BANKOLE BOWDEN President 773-793-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019027749) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019029539) |
| 122300000X Dentist (Licence: IL 019020325) | |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-10-28 |