| NPI | 1639168024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUIL MAMOOK Officer/Owner 773-267-2671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-023643) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2020-08-22 |