| 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 |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 34484 N Us Highway 45, Third Lake, Illinois |
| Authorized Official Name and Position | Olga L Thurman (PRESIDENT) |
| Authorized Official Contact | 2245414066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 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 | 1982943023 |
|---|---|
| Provider Enumeration Date | 02/09/2013 |
| Last Update Date | 02/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982943023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019027065 (Illinois) | 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 | |
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 |