| NPI | 1699110783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL SANGALANG President 312-841-3414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: FL DN19152) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2013-05-03 |