| Roots Dental Studio | |
|
5425 W 95th St Oak Lawn IL 60453-2354 | |
| (708) 636-0565 | |
| (708) 636-0566 |
| Full Name | Roots Dental Studio |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5425 W 95th St, Oak Lawn, Illinois |
| Authorized Official Name and Position | Paraj Suryakant Patel (PRESIDENT) |
| Authorized Official Contact | 7086360565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roots Dental Studio 5425 W 95th St Oak Lawn IL 60453-2354 Ph: (708) 636-0565 | Roots Dental Studio 5425 W 95th St Oak Lawn IL 60453-2354 Ph: (708) 636-0565 |
| NPI Number | 1366930604 |
|---|---|
| Provider Enumeration Date | 04/23/2018 |
| Last Update Date | 04/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366930604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
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