| Lisle Dental Center | |
|
4712 Main St Lisle IL 60532-1749 | |
| (630) 964-0944 | |
| Not Available |
| Full Name | Lisle Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4712 Main St, Lisle, Illinois |
| Authorized Official Name and Position | Sumeet Bagai (PRESIDENT) |
| Authorized Official Contact | 7733681920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisle Dental Center 4712 Main St Lisle IL 60532-1749 Ph: (630) 964-0944 | Lisle Dental Center 4712 Main St Lisle IL 60532-1749 Ph: (630) 964-0944 |
| NPI Number | 1215100508 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215100508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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