Organization
DENTIST IN BLOOMINGDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUNIL REDDY EAMANI (MANAGER)
(803) 830-6881
Entity
Organization
Contact information
Practice address
366 W ARMY TRAIL RD STE 310A, BLOOMINGDALE, IL 60108-5602
(803) 830-6881
Mailing address
366 W ARMY TRAIL RD STE 310A, BLOOMINGDALE, IL 60108-5602
(803) 830-6881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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