| NPI | 1821261397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST PANOS President 773-836-7846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021000547) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |