| NPI | 1740657774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAROSLAV R YARMOLYUK Orthodontist 773-801-7174 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021002488) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2020-01-21 |