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General NPI Number Information
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NPI Number | 1609541655
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Entity Type | Organization
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Legal Business Name | AKINWALE AKINWANDE DDS MS PLLC
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 21128 WASHINGTON PKWY
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City | FRANKFORT
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State | IL
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Zip | 60423-3112
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Country | US
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Telephone | 815-464-6465
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Fax | 815-464-6479
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Provider Business Mailing Address
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Address Line | 21128 WASHINGTON PKWY
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City | FRANKFORT
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State | IL
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Zip | 60423-3112
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Country | US
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Telephone | 815-464-6465
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Fax | 815-464-6479
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | DR. AKINWALE BANJI AKINWANDE
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Credential | DDS, MS
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Telephone | 815-464-6465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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