Provider Demographics
NPI:1285788869
Name:MAKWANA DENTAL ASSO LTD
Entity type:Organization
Organization Name:MAKWANA DENTAL ASSO LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAKWANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-994-8095
Mailing Address - Street 1:8234 SOUTH ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-4625
Mailing Address - Country:US
Mailing Address - Phone:773-994-8095
Mailing Address - Fax:
Practice Address - Street 1:8234 SOUTH ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-4625
Practice Address - Country:US
Practice Address - Phone:773-994-8095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty