| NPI | 1689065799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAILEE S PATEL Owner 312-217-4490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019-027415) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |