| NPI | 1669839593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA URSITTI Owner/Doctor 224-654-6543 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021.001777) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2022-04-02 |