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General NPI Number Information
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NPI Number | 1942689062
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Entity Type | Organization
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Legal Business Name | ELITE DENTAL SPECIALISTS
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 2124 OGDEN AVE SUITE 104
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City | AURORA
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State | IL
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Zip | 60504-7514
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Country | US
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Telephone | 630-585-6100
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Fax | 630-585-6107
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Provider Business Mailing Address
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Address Line | 2124 OGDEN AVE SUITE 104
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City | AURORA
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State | IL
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Zip | 60504-7514
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Country | US
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Telephone | 630-585-6100
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Fax | 630-585-6107
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Authorized Official
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Title or Position | OWNER OF PRACTICE
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Name | DR. ANEEL BELANI
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Credential | DDS
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Telephone | 630-585-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 019027694
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License Number State | PA
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