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General NPI Number Information
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NPI Number | 1033938501
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Entity Type | Organization
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Legal Business Name | MEGHANA PRABHA DDS PC
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 2202 1/2 ALGONQUIN RD
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City | ROLLING MEADOWS
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State | IL
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Zip | 60008-3608
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Country | US
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Telephone | 847-870-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 CREEK BEND DR
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City | VERNON HILLS
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State | IL
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Zip | 60061-3307
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Country | US
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Telephone | 847-222-3760
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MEGHANA V PRABHA
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Credential | DDS
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Telephone | 847-222-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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