| Stratford Square Periodontics | |
|
290 Springfield Drive Suite 140 Bloomingdale IL 60108 | |
| (630) 582-3120 | |
| (630) 582-3137 |
| Full Name | Stratford Square Periodontics |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 290 Springfield Drive, Bloomingdale, Illinois |
| Authorized Official Name and Position | Juzer Chinwalla (OWNER) |
| Authorized Official Contact | 6305823120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stratford Square Periodontics 290 Springfield Drive Suite 140 Bloomingdale IL 60108 Ph: (630) 582-3120 | Stratford Square Periodontics 290 Springfield Drive Suite 140 Bloomingdale IL 60108 Ph: (630) 582-3120 |
| NPI Number | 1679629331 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 01/28/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679629331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 019023850 (Illinois) | Primary |
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