Provider Demographics
NPI:1508244203
Name:AFFORDABLE DENTURES - OAK PARK, P.C.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - OAK PARK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-237-5816
Mailing Address - Street 1:2700 N NARRAGANSETT AVE
Mailing Address - Street 2:SUITE F-3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-1083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2700 N NARRAGANSETT AVE
Practice Address - Street 2:SUITE F-3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1083
Practice Address - Country:US
Practice Address - Phone:773-237-5816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029457122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty