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General NPI Number Information
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NPI Number | 1699020966
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Entity Type | Organization
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Legal Business Name | TEJAS JOSHI P.C
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | 2958 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-1556
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Country | US
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Telephone | 773-262-4242
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Fax | 773-293-6436
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Provider Business Mailing Address
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Address Line | 2958 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60659-1556
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Country | US
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Telephone | 773-262-4242
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Fax | 773-293-6436
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Authorized Official
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Title or Position | OWNER
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Name | DR. TEJAS N JOSHI
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Credential | D.M.D
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Telephone | 773-262-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019027387
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License Number State | IL
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