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General NPI Number Information
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NPI Number | 1265654347
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Entity Type | Individual
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Provider Name | AMIT SAPARIA D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 134 W 111TH ST 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60628-4215
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Country | US
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Telephone | 773-995-3024
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Fax |
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Provider Business Mailing Address
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Address Line | 3449 193RD ST
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City | LANSING
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State | IL
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Zip | 60438-3862
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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 |
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Name |
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Credential |
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Telephone |
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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 | 19027052
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License Number State | IL
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