Organization
DEEPA SRIDHAR P.C
Active
Other names
Placida
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPA SRIDHAR DMD (PRESIDENT)
(630) 313-4918
Entity
Organization
Contact information
Practice address
217 S BOLINGBROOK DR, BOLINGBROOK, IL 60440-2931
(630) 313-4918
(630) 626-4784
Mailing address
217 S BOLINGBROOK DR, BOLINGBROOK, IL 60440-2931
(630) 313-4918
(630) 626-4784
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026471
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178432
—
IL
Enumeration date
02/11/2015
Last updated
02/11/2015
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