| NPI | 1992870455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOGHRA MOJGAN SOROURI Owner 773-478-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024208) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2013-09-09 |