Organization
INNOVATIVE DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIMPLE TEJANI (MEMBER)
(312) 368-6400
Entity
Organization
Contact information
Practice address
20 E WASHINGTON ST, SUITE 1300, CHICAGO, IL 60602
(312) 368-6400
Mailing address
20 E WASHINGTON ST, SUITE 1300, CHICAGO, IL 60602
(312) 368-6400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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