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General NPI Number Information
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NPI Number | 1326818667
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Entity Type | Organization
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Legal Business Name | MUNSTER DENTISTRY LLC
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Dates
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Enumeration Date | 01/08/2024
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 310 RIDGE RD
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City | MUNSTER
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State | IN
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Zip | 46321-1528
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Country | US
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Telephone | 630-835-0545
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Fax |
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Provider Business Mailing Address
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Address Line | 1S132 SUMMIT AVE STE 102
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-3931
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Country | US
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Telephone | 630-247-7216
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAHUL JADHAV
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Credential |
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Telephone | 630-247-7216
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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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