NPI | 1992838551 |
---|---|
Entity Type | Organization |
Authorized Contact | MYROSLAW DYCHIY President 773-486-5264 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19026279) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2020-08-22 |