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General NPI Number Information
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NPI Number | 1699917153
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Entity Type | Organization
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Legal Business Name | KRISHAN DENTAL LIMITED
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 825 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-5900
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Country | US
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Telephone | 815-726-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 2743 STOCKTON RD
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City | NAPERVILLE
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State | IL
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Zip | 60564-9470
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Country | US
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Telephone | 773-742-8471
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHWETA KAMAL
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Credential | D.D.S.
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Telephone | 815-726-6000
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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 | 019026341
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License Number State | IL
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