Individual
DR. KAVITA GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1200 S YORK RD, SUITE 3110, ELMHURST, IL 60126-5626
(630) 782-6999
(630) 782-6790
Mailing address
1200 S YORK RD, SUITE 3110, ELMHURST, IL 60126-5626
(630) 782-6999
(630) 782-6790
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023007
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019023007
STATE LICENSE
IL
Enumeration date
11/07/2006
Last updated
01/13/2011
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