| NPI | 1679646962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY CHANG Owner 773-772-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-025589) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2023-03-07 |