| NPI | 1932543329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SACHIN VERMA Dentist 224-800-1432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019028017) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IL 137000782) |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2013-04-29 |