Provider Demographics
NPI:1023732989
Name:NAMRATA RAVAL DDS P. C.
Entity type:Organization
Organization Name:NAMRATA RAVAL DDS P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAMRATA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHANSALI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-550-6094
Mailing Address - Street 1:4 E OGDEN AVE # 177
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-3506
Mailing Address - Country:US
Mailing Address - Phone:630-550-6094
Mailing Address - Fax:
Practice Address - Street 1:930 N YORK RD STE 120
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2994
Practice Address - Country:US
Practice Address - Phone:630-550-6094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty