| NPI | 1932443793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARIE TAN Orthodontist 312-404-5393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: HI DT-2464) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2012-11-19 |