| NPI | 1720446842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILIYA TANEVA President 312-504-7972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-02-03 |