| Pure Dental Spa | |
|
1222 W Madison St Suite 300 Chicago IL 60607-2044 | |
| (312) 988-0025 | |
| (312) 757-1898 |
| Full Name | Pure Dental Spa |
|---|---|
| Speciality | Dentist |
| Location | 1222 W Madison St, Chicago, Illinois |
| Authorized Official Name and Position | Rajul K Patel (PRESIDENT/DENTIST) |
| Authorized Official Contact | 3129880025 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Dental Spa 1222 W Madison St Suite 300 Chicago IL 60607-2044 Ph: (312) 988-0025 | Pure Dental Spa 1222 W Madison St Suite 300 Chicago IL 60607-2044 Ph: (312) 988-0025 |
| NPI Number | 1497209407 |
|---|---|
| Provider Enumeration Date | 08/08/2016 |
| Last Update Date | 08/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497209407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027791 (Illinois) | Primary |
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