Provider Demographics
NPI:1346355856
Name:VPDENTAL LLC
Entity Type:Organization
Organization Name:VPDENTAL LLC
Other - Org Name:TOWERSTATIONDENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AJITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARUCHURI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:630-293-7777
Mailing Address - Street 1:956 N NELTNOR BLVD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5982
Mailing Address - Country:US
Mailing Address - Phone:630-293-7777
Mailing Address - Fax:630-293-7773
Practice Address - Street 1:956 N NELTNOR BLVD
Practice Address - Street 2:SUITE 316
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-5982
Practice Address - Country:US
Practice Address - Phone:630-293-7777
Practice Address - Fax:630-293-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026362261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental