Provider Demographics
NPI:1528380557
Name:AURORA FAMILY DENTAL INC
Entity Type:Organization
Organization Name:AURORA FAMILY DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEHABEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-820-8550
Mailing Address - Street 1:475 N. FARNSWORTH AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-3005
Mailing Address - Country:US
Mailing Address - Phone:630-820-8550
Mailing Address - Fax:
Practice Address - Street 1:475 N FARNSWORTH AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-3004
Practice Address - Country:US
Practice Address - Phone:630-820-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.265961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty