Provider Demographics
NPI:1760794176
Name:DENTAL WISH LTD
Entity Type:Organization
Organization Name:DENTAL WISH LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-660-8929
Mailing Address - Street 1:414 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-2535
Mailing Address - Country:US
Mailing Address - Phone:773-277-8834
Mailing Address - Fax:773-277-8873
Practice Address - Street 1:4101 W 26TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60623-4313
Practice Address - Country:US
Practice Address - Phone:773-277-8834
Practice Address - Fax:773-277-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190270061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty