| NPI | 1922407667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD REZA EKHTERA President 773-564-9916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2025-10-20 |