| NPI | 1922527852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD TORRANCE BAKER Managing Member 773-493-4937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 19-025166) |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2019-11-18 |