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NPI Code Detail

MEDICARE: MANJEEV MALHOTRA DDS

MEDICARE:   MANJEEV  MALHOTRA  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry019022800IL

General Provider Information

NPI Number : 1790936698
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANJEEV MALHOTRA DDS
Provider Business Mailing Address
First Line : 19558 S. HARLEM AVE
Second Line : SUITE 1
City : FRANKFORT
State : IL
Zip : 60423-6743
Country : US
Telephone Number : 815-469-1900
Fax Number : 815-469-1906
Provider Business Practice Location Address
First Line : 19558 S. HARLEM AVE.
Second Line : SUITE 1
City : FRANKFORT
State : IL
Zip : 60423-6743
Country : US
Telephone Number : 815-469-1900
Fax Number : 815-469-1906
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2008
Last Update Date : 10/09/2008

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Directions to “ MANJEEV MALHOTRA DDS” Practice Location

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