Organization
ISLAND LAKE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKHAR SHAH DMD (PRESIDENT)
(630) 765-1762
Entity
Organization
Contact information
Practice address
510 AUBURN DR STE D, ISLAND LAKE, IL 60042-9105
(630) 765-1762
Mailing address
232 STONINGTON DR, BLOOMINGDALE, IL 60108-7810
(630) 765-1762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/23/2024
Last updated
01/23/2024
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