| 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 |