Organization
GALLERIA DENTAL
Active
Parent organization
ASHTON DENTAL PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASHTON DENTAL PC
Authorized official
SOHAIL S SHAFI (MANAGER)
(630) 842-3705
Entity
Organization
Contact information
Practice address
1535 S LAKE ST, MUNDELEIN, IL 60060-4210
(847) 566-1900
(847) 566-1904
Mailing address
1730 PARK ST STE 106, NAPERVILLE, IL 60563-2609
(847) 566-1900
(847) 566-1904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/28/2014
Last updated
12/10/2020
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