NPI | 1770211344 |
---|---|
Entity Type | Organization |
Authorized Contact | MALIHA KHAN Authorized Official 773-536-1155 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2022-08-11 |
Last Update Date | 2022-08-11 |