Prakash K. Upadhyaya DDS Ltd.

NPI #1003236555 in Broadview, Illinois

Provider Information

NPI Number: 1003236555
Entity Type: Organization
Organization Name: Prakash K. Upadhyaya DDS Ltd.
Subpart: Yes (part of a larger organization)
Parent Organization: PRAKASH K. UPADHYAYA DDS LTD.
Primary Specialty: Dentist
Enumeration Date: Apr 23, 2014
Last Updated: Apr 23, 2014

Practice Location

Address: 2400 W ROOSEVELT RD
Address 2: SUITE #1
City: Broadview
State: Illinois
ZIP Code: 60155-3880
Phone: (708) 865-2400

Authorized Official

Name: DR. PRAKASH K UPADHYAYA, D.D.S.
Title: GENERAL DENTIST
Phone: (708) 865-2400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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