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General NPI Number Information
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NPI Number | 1740309632
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Entity Type | Organization
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Legal Business Name | STONEHILL DENTAL PC
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 60C S MAIN ST
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City | OSWEGO
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State | IL
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Zip | 60543-8594
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Country | US
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Telephone | 630-554-7725
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Fax | 630-554-7726
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Provider Business Mailing Address
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Address Line | 60C S MAIN ST
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City | OSWEGO
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State | IL
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Zip | 60543-8594
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Country | US
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Telephone | 630-554-7725
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Fax | 630-554-7726
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Authorized Official
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Title or Position | TREASURER
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Name | SHALINI MOHAN
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Credential | DMD
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Telephone | 630-554-7725
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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 |
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