Organization
YOURTHODONTIST LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEENAKSHI BALAKRISHNAN D.M.D., M.S. (PRESIDENT)
(630) 515-2727
Entity
Organization
Contact information
Practice address
1330 OGDEN AVENUE, DOWNERS GROVE, IL 60515-2772
(630) 515-2727
(419) 735-6033
Mailing address
195 NORTH HARBOR DRIVE, #1304, CHICAGO, IL 60601-7528
(630) 515-2727
(419) 735-6033
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
05/14/2007
Last updated
08/28/2007
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