| NPI | 1679904171 |
|---|---|
| Doing Business As | PRIMARY FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | KALPANA SHAH President 815-727-5813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019025713) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |