| Innova Family Dental | |
|
772 S Weber Rd Bolingbrook IL 60490-5472 | |
| (630) 518-2272 | |
| (630) 243-4778 |
| Full Name | Innova Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 772 S Weber Rd, Bolingbrook, Illinois |
| Authorized Official Name and Position | Kalpana N Kandimalla (OWNER DENTIST) |
| Authorized Official Contact | 6305182272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innova Family Dental 772 S Weber Rd Bolingbrook IL 60490-5472 Ph: (630) 518-2272 | Innova Family Dental 772 S Weber Rd Bolingbrook IL 60490-5472 Ph: (630) 518-2272 |
| NPI Number | 1558994392 |
|---|---|
| Provider Enumeration Date | 02/20/2020 |
| Last Update Date | 06/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558994392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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