Individual
DR. MALAVIKA PRASANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BDS,DDS
Contact information
Practice address
2537 W NORTH AVE, MELROSE PARK, IL 60160-1121
(312) 274-0308
Mailing address
430 W ERIE ST, SUITE 200, CHICAGO, IL 60654-6914
(920) 838-1649
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028441
IL
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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