Provider Demographics
NPI:1083270763
Name:AURA DENTAL STUDIO INC
Entity Type:Organization
Organization Name:AURA DENTAL STUDIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSHANT
Authorized Official - Middle Name:
Authorized Official - Last Name:DHADWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-592-8139
Mailing Address - Street 1:17W615 BUTTERFIELD RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17W615 BUTTERFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4001
Practice Address - Country:US
Practice Address - Phone:630-592-8139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-17
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty