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General NPI Number Information
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NPI Number | 1750642609
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Entity Type | Organization
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Legal Business Name | HBP DENTAL PC
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 440 E ROOSEVELT RD SUITE 112
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City | WEST CHICAGO
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State | IL
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Zip | 60185-3918
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Country | US
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Telephone | 847-909-0703
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Fax |
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Provider Business Mailing Address
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Address Line | 440 E ROOSEVELT RD SUITE 112
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City | WEST CHICAGO
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State | IL
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Zip | 60185-3918
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Country | US
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Telephone | 847-909-0703
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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. HETAL B PATEL
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Credential | DDS
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Telephone | 847-909-0703
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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 | 019027323
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License Number State | IL
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