Organization
MEDA DENTAL,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SATHYA MEDA NAGA DDS (OWNER)
(630) 416-8080
Entity
Organization
Contact information
Practice address
2801 OGDEN AVE STE 4, LISLE, IL 60532-1993
(630) 416-8080
(630) 416-8141
Mailing address
2801 OGDEN AVE STE 4, LISLE, IL 60532-1993
(630) 416-8080
(630) 416-8141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027401
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9200349
—
IL
Enumeration date
08/03/2009
Last updated
08/03/2009
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