Healthcare Provider Details
I. General information
NPI: 1598463390
Provider Name (Legal Business Name): 32 DENTAL 4U
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2023
Last Update Date: 02/21/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3218 KIRCHOFF ROAD
ROLLING MEADOWS IL
60008
US
IV. Provider business mailing address
3218 KIRCHOFF ROAD
ROLLING MEADOWS IL
60008
US
V. Phone/Fax
- Phone: 847-305-4041
- Fax: 847-305-2674
- Phone: 847-305-4041
- Fax: 847-305-2674
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PRASUDHA
KARTEEKA
SUNKARA
Title or Position: PRESIDENT
Credential: DMD
Phone: 847-212-4340