Individual
PRAKASH K UPADHYAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5110 W CHICAGO AVE, CHICAGO, IL 60651
(773) 378-3636
Mailing address
7 FOUNDERS POINTE NORTH, BLOOMINGDALE, IL 60108
(773) 378-3636
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
12/04/2006
Last updated
07/08/2007
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