| NPI | 1720316904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALMAAN POOTHAWALA President 847-208-6558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019026329) |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2009-11-25 |