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General NPI Number Information
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NPI Number | 1104417849
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Entity Type | Organization
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Legal Business Name | TOPLINE SPECIALTY DENTAL P.C.
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 1521 OGDEN AVE STE 109
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City | AURORA
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State | IL
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Zip | 60503-9300
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Country | US
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Telephone | 630-984-1112
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Fax |
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Provider Business Mailing Address
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Address Line | 3804 NANNYBERRY CT
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City | NAPERVILLE
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State | IL
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Zip | 60564-2022
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Country | US
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Telephone | 847-890-2186
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RATHIDEVI SUBRAMANI
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Credential | DDS
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Telephone | 847-890-2186
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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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