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General NPI Number Information
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NPI Number | 1114727708
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Entity Type | Organization
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Legal Business Name | CHICAGO IMPLANT STUDIO OF AURORA
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 2460 S EOLA RD STE K
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City | AURORA
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State | IL
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Zip | 60503-6495
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Country | US
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Telephone | 331-257-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 914 SAINT STEPHENS GRN
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City | OAK BROOK
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State | IL
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Zip | 60523-2568
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Country | US
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Telephone | 203-215-2487
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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. SEYEDAMIR DANESH SANI
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Credential | DDS
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Telephone | 203-215-2487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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