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General NPI Number Information
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NPI Number | 1538901848
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Entity Type | Organization
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Legal Business Name | DENTAL PLANET LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 711 PLAZA DR STE 6
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City | CHESTERTON
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State | IN
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Zip | 46304-5506
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Country | US
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Telephone | 219-484-9587
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 S PRAIRIE AVE UNIT 1901
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City | CHICAGO
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State | IL
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Zip | 60605-3087
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Country | US
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Telephone | 562-331-0210
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MUHANAD AL KHATIB
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Credential | DMD
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Telephone | 562-331-0210
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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 |
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License Number State |
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