| Pure Dental Spa | |
|
107 W Lake St Suite 101 Bloomingdale IL 60108 | |
| (630) 307-3133 | |
| (630) 307-3134 |
| Full Name | Pure Dental Spa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 107 W Lake St Suite 101, Bloomingdale, Illinois |
| Authorized Official Name and Position | Rajul Patel (DENTIST/OWNER) |
| Authorized Official Contact | 6303073133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Dental Spa 107 W Lake St Suite 101 Bloomingdale IL 60108 Ph: (630) 307-3133 | Pure Dental Spa 107 W Lake St Suite 101 Bloomingdale IL 60108 Ph: (630) 307-3133 |
| NPI Number | 1427362771 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 12/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427362771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027791 (Illinois) | Primary |
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