| Northgate Dental Center | |
|
900 N Lake St Aurora IL 60506-2535 | |
| (630) 892-0015 | |
| (630) 892-9902 |
| Full Name | Northgate Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 900 N Lake St, Aurora, Illinois |
| Authorized Official Name and Position | Surekha Sakala (PRESIDENT) |
| Authorized Official Contact | 6308920015 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northgate Dental Center 900 N Lake St Aurora IL 60506-2535 Ph: (630) 892-0015 | Northgate Dental Center 900 N Lake St Aurora IL 60506-2535 Ph: (630) 892-0015 |
| NPI Number | 1841346574 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841346574 | NPI | - | NPPES |
| 9179987 | Medicaid | IL | |
| 1004389 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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