| NPI | 1669693669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYRA D BARNES Owner 773-873-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019220) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |