| NPI | 1932416898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN VONGLUEKIAT Owner 312-791-0920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019027652) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2010-09-13 |