| NPI | 1770356529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN URIBE CARDENAS CEO 630-339-3438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2023-11-02 |
| Last Update Date | 2024-04-16 |