Dental On 45 Inc | |
34484 N Us Highway 45 Suite C Third Lake IL 60030-4038 | |
(224) 541-4066 | |
(847) 752-8425 |
Full Name | Dental On 45 Inc |
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Speciality | Dentist |
Location | 34484 N Us Highway 45, Third Lake, Illinois |
Authorized Official Name and Position | Marlen Fajardo (OFFICE MANAGER) |
Authorized Official Contact | 2245414066 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dental On 45 Inc 34484 N Us Highway 45 Suite C Third Lake IL 60030-4038 Ph: (224) 541-4066 | Dental On 45 Inc 34484 N Us Highway 45 Suite C Third Lake IL 60030-4038 Ph: (224) 541-4066 |
NPI Number | 1184033839 |
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Provider Enumeration Date | 08/07/2014 |
Last Update Date | 08/07/2014 |
Identifier | Type | State | Issuer |
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1184033839 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | (* (Not Available)) | Primary |
Dental On 45 Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 34484 N Us Highway 45, Suite C, Third Lake, IL 60030 Phone: 224-541-4066 Fax: 847-752-8425 | |
Nataliya Korniychuk Dmd Ltd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 34484 N Us Highway 45, Suite C, Third Lake, IL 60030 Phone: 224-541-4066 | |
Dental On 45 Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 34484 N Us Highway 45, Suite C, Third Lake, IL 60030 Phone: 224-541-4066 Fax: 847-752-8425 |