| NPI | 1730898933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED QAISI Owner 773-296-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2022-11-16 |