Organization
SHINAYA007 DENTISTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHOBHIT BANSAL (DENTIST)
(646) 703-3924
Entity
Organization
Contact information
Practice address
1576 WEST LANE RD, MACHESNEY PARK, IL 60142
(646) 703-3924
Mailing address
12471 GLAZIER ST, HUNTLEY, IL 60142-6072
(646) 703-3924
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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