| NPI | 1699162693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARDESHIR RAGHIAN General Dentist 773-252-0033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024426) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |