| NPI | 1912588930 |
|---|---|
| Doing Business As | SOUTHWEST PEDIATRIC DENTAL |
| Entity Type | Organization |
| Authorized Contact | JAMES MITSOS Owner 708-557-5584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-04-20 |