NPI | 1649442344 |
---|---|
Doing Business As | LOGAN SQUARE DENTAL GROUP |
Entity Type | Organization |
Authorized Contact | IAN WILLIAM HOFFMAN President 773-227-2587 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Enumeration Date | 2008-04-02 |
Last Update Date | 2008-04-02 |