| Fox Valley Dental Associates Of Crystal Lake Llc | |
|
360 N Terra Cotta Rd Suite #d Crystal Lake IL 60012-3749 | |
| (815) 477-0770 | |
| (815) 444-8841 |
| Full Name | Fox Valley Dental Associates Of Crystal Lake Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 360 N Terra Cotta Rd, Crystal Lake, Illinois |
| Authorized Official Name and Position | Gregg R Hornyak (GENERAL DENTIST MANAGING MEMBER) |
| Authorized Official Contact | 8154770770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox Valley Dental Associates Of Crystal Lake Llc 360 N Terra Cotta Rd Suite #d Crystal Lake IL 60012-3749 Ph: (815) 477-0770 | Fox Valley Dental Associates Of Crystal Lake Llc 360 N Terra Cotta Rd Suite #d Crystal Lake IL 60012-3749 Ph: (815) 477-0770 |
| NPI Number | 1972646925 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972646925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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