Provider Demographics
NPI:1871014860
Name:VALLEY VIEW DENTAL - MONTGOMERY LLC
Entity Type:Organization
Organization Name:VALLEY VIEW DENTAL - MONTGOMERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:PRADEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-372-0100
Mailing Address - Street 1:1078 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-5404
Mailing Address - Country:US
Mailing Address - Phone:630-923-0900
Mailing Address - Fax:
Practice Address - Street 1:1078 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-5404
Practice Address - Country:US
Practice Address - Phone:630-923-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty