| NPI | 1801186986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATEMEH KHAGHANI Dentist 773-871-0336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |