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Organization
SPARK DENTAL PC
Active
Organization
SPARK DENTAL PC
Active
Other names
SPARK DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
NISHU SHARMA (PRESIDENT)
(630) 672-7877
Entity
Organization
Contact information
Practice address
1050 S BARRINGTON RD STE A, STREAMWOOD, IL 60107-2464
(630) 672-7877
Mailing address
PO BOX 597, SOUTH ELGIN, IL 60177-0597
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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