Organization
KP DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH PATEL (PRESIDENT)
(312) 213-0612
Entity
Organization
Contact information
Practice address
704 N GREENWOOD AVE, PARK RIDGE, IL 60068-2508
(312) 213-0612
Mailing address
704 N GREENWOOD AVE, PARK RIDGE, IL 60068-2508
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030455
IL
Other
Enumeration date
12/19/2015
Last updated
12/19/2015
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