| NPI | 1720433915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEPAK NEDUVELIL Owner 312-759-1120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027964) |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |