Individual
DR. PUJA BHAGWAKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1620 S MICHIGAN AVE UNIT 704, CHICAGO, IL 60616
(630) 303-7852
Mailing address
1620 S MICHIGAN AVE UNIT 704, CHICAGO, IL 60616-4691
(630) 303-7852
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031830
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2018
Last updated
08/14/2018
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