| NPI | 1881893147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON KORKUS President 773-484-1201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019025111) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |