| NPI | 1730976382 |
|---|---|
| Doing Business As | PINE RIDGE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MANUEL COBOS COO 773-398-5423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-04-24 |