Organization
MANJOTE K DHALIWAL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANJOTE DHALIWAL (PEDIATRIC DENTIST)
(917) 664-5120
Entity
Organization
Contact information
Practice address
160 COMMERCE DR STE 100, GRAYSLAKE, IL 60030-1603
(847) 223-1400
Mailing address
160 COMMERCE DR STE 100, GRAYSLAKE, IL 60030-1603
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.027589
IL
Other
Enumeration date
02/17/2011
Last updated
03/15/2011
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