| NPI | 1649496514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES STANLEY CZEREPAK President 773-880-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.001086) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2020-08-22 |