Provider Demographics
NPI:1447617386
Name:CSG DENTAL I, P.C.
Entity Type:Organization
Organization Name:CSG DENTAL I, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-847-1260
Mailing Address - Street 1:1 E WACKER DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-1474
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 E WACKER DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-1474
Practice Address - Country:US
Practice Address - Phone:773-847-1260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty