# SUDHIR K. BHATIA DDS MS LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902294291
- **Authorized official:** DR. SUDHIR KUMAR BHATIA DDS (PRESIDENT OF CORPORATION)
- **Authorized official phone:** (630) 725-0947

## Contact information

- **Practice address:** 7451 WOODWARD AVE, SUITE 102, WOODRIDGE, IL 60517-2665
- **Practice address phone:** (630) 725-0947
- **Practice address fax:** (630) 725-0949
- **Mailing address:** 7451 WOODWARD AVE, SUITE 102, WOODRIDGE, IL 60517-2665
- **Mailing address phone:** (630) 725-0947
- **Mailing address fax:** (630) 725-0949

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 019015183 | IL | Yes |

## Other

- **Enumeration date:** 01/08/2015
- **Last updated:** 01/08/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1245316546 | — | IL |