NPI | 1659696995 |
---|---|
Entity Type | Organization |
Authorized Contact | VLAD FERDKOFF President 312-751-1113 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019024754) |
Enumeration Date | 2010-03-30 |
Last Update Date | 2010-03-30 |