Edc Of Lemont PLLC
Dentist in Lemont, IL. Organization (NPI-2).
NPI number1740959345
StatusActive
Last updated in NPPESApr 25, 2023
Details
- NPI
- 1740959345
- Entity type
- Organization (NPI-2)
- Legal business name
- Edc Of Lemont PLLC
- Organization subpart
- No
- Enumeration date
- Sep 8, 2021
- Certification date
- Apr 25, 2023
- Last updated
- Apr 25, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Dentique - Lemont (Doing Business As)
Practice location
15543 E 127th St Ste 103Lemont, IL 60439-8584
Phone 630-243-8300 · Fax 630-243-9493
Mailing address
15543 E 127th St Ste 103Lemont, IL 60439-8584
Phone 630-243-8300 · Fax 630-243-9493
Authorized official
Pradeep Khurana
Owner
3123999595
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