| NPI | 1912236878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EJAZ TAHIR Orthodontist 708-484-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019022990) |
| Enumeration Date | 2009-12-23 |
| Last Update Date | 2009-12-23 |