| NPI | 1992046205 |
|---|---|
| Doing Business As | EDGEBROOK DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | SAM DAUAHERA Owner 773-456-5659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027577) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |