| NPI | 1912783705 |
|---|---|
| Doing Business As | WICKER PARK DENTAL STUDIO, LTD |
| Entity Type | Organization |
| Authorized Contact | LESLIE SANDERS Owner/Dentist 630-346-9383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-24 |