Individual
DR. DEEPA SRIDHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
217 S BOLINGBROOK DR, BOLINGBROOK, IL 60440-2931
(630) 313-4918
Mailing address
2952 FOREST CREEK LN, NAPERVILLE, IL 60565-3579
(312) 731-7713
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-026471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178432
—
IL
Enumeration date
12/13/2006
Last updated
03/18/2015
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