| NPI | 1720351448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISOULA GEORGACOULOS D.M.D 708-687-4256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 363692279) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-13 |