Organization
GRAND DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPAN PRAVIN PATEL DND (DENTIST)
(616) 443-5097
Entity
Organization
Contact information
Practice address
116 W GRAND AVE, #1, CHICAGO, IL 60654-5207
(312) 955-9020
Mailing address
116 W GRAND AVE, #1, CHICAGO, IL 60654-5207
(312) 955-9020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028510
IL
Other
Enumeration date
05/01/2014
Last updated
05/01/2014
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