| NPI | 1700288164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEENA R PATEL President 224-399-9535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019028494) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |