Organization
ASHTON DENTAL PC
Active
Other names
Eco Dental
Organization subpart
No
Provider details
NPI number
Authorized official
SOHAIL S SHAFI (MANAGER)
(630) 842-3705
Entity
Organization
Contact information
Practice address
14403 S BELL RD, HOMER GLEN, IL 60491-7881
(331) 431-9059
Mailing address
1730 PARK ST STE 106, NAPERVILLE, IL 60563-2609
(708) 966-4018
(708) 966-2188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019024809
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019024809
—
IL
Enumeration date
02/06/2015
Last updated
12/10/2020
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