| NPI | 1811516479 |
|---|---|
| Doing Business As | MOUTHPEACE DENTAL |
| Entity Type | Organization |
| Authorized Contact | SYRETTA WELLS Owner /Dentist 312-371-1423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |