| NPI | 1780810630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJAN SHARMA Owner 773-667-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021-001569) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 021-001569) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |