NPI | 1790095065 |
---|---|
Doing Business As | EVANSTON CHILDRENS DENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | EVONDA THOMAS Director 847-844-2957 |
Organization Subpart ? | No |
Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: IL 074390907) |
Enumeration Date | 2010-10-20 |
Last Update Date | 2010-10-20 |