Two Rivers Dental

NPI #1760712855 in Bolingbrook, Illinois

Provider Information

NPI Number: 1760712855
Entity Type: Organization
Organization Name: Two Rivers Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 12, 2010
Last Updated: Dec 10, 2020

Practice Location

Address: 1196 W BOUGHTON RD
City: Bolingbrook
State: Illinois
ZIP Code: 60440-6567
Phone: (630) 759-9929

Authorized Official

Name: SOHAIL S SHAFI
Title: MANAGER
Phone: (630) 842-3705

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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