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Organization
OSWEGO DENTAL
Active
Organization
OSWEGO DENTAL
Active
Parent organization
TWO RIVERS DENTAL PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TWO RIVERS DENTAL PC
Authorized official
SOHAIL S SHAFI (MANAGER)
(630) 842-3705
Entity
Organization
Contact information
Practice address
2484 ROUTE 30, OSWEGO, IL 60543
(630) 801-1999
(630) 801-1919
Mailing address
1730 PARK ST STE 106, NAPERVILLE, IL 60563-2609
(630) 801-1999
(630) 801-1919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/27/2010
Last updated
12/10/2020
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