| NPI | 1811026669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE MICHAEL REUBEN Oral Surgeon 773-777-6332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-08-22 |