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General NPI Number Information
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NPI Number | 1710363734
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Entity Type | Organization
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Legal Business Name | SK DENTAL ASSOCIATES PC
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 495 ROUTE 47 SUITE J
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City | SUGAR GROVE
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State | IL
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Zip | 60554
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Country | US
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Telephone | 630-466-1100
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Fax | 630-466-7933
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Provider Business Mailing Address
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Address Line | 495 ROUTE 47 SUITE J
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City | SUGAR GROVE
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State | IL
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Zip | 60554
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Country | US
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Telephone | 630-466-1100
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Fax | 630-466-7933
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | DR. SIBTAIN KERAI
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Credential | DDS
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Telephone | 630-466-1100
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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 |
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License Number State | IL
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