| Deer Park Dental Ltd | |
|
21660 W. Field Parkway Deer Park IL 60010 | |
| (847) 438-9669 | |
| (847) 438-9660 |
| Full Name | Deer Park Dental Ltd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21660 W. Field Parkway, Deer Park, Illinois |
| Authorized Official Name and Position | Bruce Privatsky (OWNER) |
| Authorized Official Contact | 8474389669 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deer Park Dental Ltd 21660 W. Field Parkway Deer Park IL 60010 Ph: (847) 438-9669 | Deer Park Dental Ltd 21660 W. Field Parkway Deer Park IL 60010 Ph: (847) 438-9669 |
| NPI Number | 1700101326 |
|---|---|
| Provider Enumeration Date | 04/07/2010 |
| Last Update Date | 04/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700101326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019021596 (Illinois) | Primary |
Oral Facial & Implant Specialists, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 21660 W Field Pkwy, Suite 220, Deer Park, IL 60010 Phone: 847-381-0106 Fax: 847-381-0265 |