Organization
CLOVE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANDEEP THOTA DMD (PRESIDENT)
(314) 651-6550
Entity
Organization
Contact information
Practice address
4207 N PROSPECT RD, PEORIA HEIGHTS, IL 61616-7754
(309) 323-8884
(309) 324-3336
Mailing address
4207 N PROSPECT RD, PEORIA HEIGHTS, IL 61616-7754
(309) 323-8884
(309) 324-3336
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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