| NPI | 1639239478 |
|---|---|
| Former Legal Business Name | PERLA DENTAL |
| Entity Type | Organization |
| Authorized Contact | VICKEN ICHKHAN Dentist 773-521-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-024873) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2008-03-28 |