Organization
PRAKASH K. UPADHYAYA DDS LTD.
Active
Parent organization
PRAKASH K. UPADHYAYA DDS LTD.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRAKASH K. UPADHYAYA DDS LTD.
Authorized official
DR. PRAKASH K UPADHYAYA D.D.S. (GENERAL DENTIST)
(708) 865-2400
Entity
Organization
Contact information
Practice address
2400 W ROOSEVELT RD, SUITE #1, BROADVIEW, IL 60155-3880
(708) 865-2400
Mailing address
2400 W ROOSEVELT RD, SUITE #1, BROADVIEW, IL 60155-3880
(708) 865-2400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019015678
IL
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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