Individual
INDRU PUNWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
801 S PAULINA ST, MC 621, CHICAGO, IL 60612-7210
(312) 996-3544
Mailing address
801 S PAULINA ST, MC 621, CHICAGO, IL 60612-7210
(312) 996-3544
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019015237
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019015237
—
IL
Enumeration date
02/23/2007
Last updated
07/09/2007
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