| NPI | 1821263740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HORACE C. BROY Dentist 773-536-1434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022596) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |