| NPI | 1639412380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CHANG President 219-201-6101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027803) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2013-04-01 |