| NPI | 1558994392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALPANA N KANDIMALLA Owner Dentist 630-518-2272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2020-02-20 |
| Last Update Date | 2022-06-21 |