| NPI | 1811413719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAIYAN CHEN President 708-689-9558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.029414) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019.029414) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |