| NPI | 1669620902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUNJAN JAIN Manager 708-425-4301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: IL 019027447) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2022-03-14 |