| NPI | 1952959074 |
|---|---|
| Doing Business As | PLEASE SELECT |
| Entity Type | Organization |
| Authorized Contact | KERRY L LOWERY Dentist 773-771-2605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-09-02 |
| Last Update Date | 2019-09-02 |