| NPI | 1669499505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER ALBERT NOUNEH Managing Member 312-927-8882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: IL 021001990) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-08-22 |