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General NPI Number Information
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NPI Number | 1245636802
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Entity Type | Organization
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Legal Business Name | SOFT TOUCH DENTAL PC
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 3142 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60623-3306
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Country | US
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Telephone | 248-245-5467
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Fax |
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Provider Business Mailing Address
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Address Line | 3142 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60623-3306
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LAKSHMI WAKADE
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Credential | D.D.S.
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Telephone | 248-245-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.029652
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License Number State | IL
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