| NPI | 1699868364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANA C HERNANDEZ Office Manager 773-947-4665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019022626) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2008-06-11 |