| NPI | 1962753210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARTLOMIEJ LECH NIERZWICKI Owner 773-838-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IL 021002267) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2012-09-26 |