| NPI | 1720245491 |
|---|---|
| Other Name | SPANG SOUTH DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | HEIDI NELSON Controller 773-751-4107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 016) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |