| Performance Dental Care Pc | |
|
7230 191st St Tinley Park IL 60487-9378 | |
| (815) 464-8850 | |
| (708) 777-4797 |
| Full Name | Performance Dental Care Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7230 191st St, Tinley Park, Illinois |
| Authorized Official Name and Position | Kevin L Fatland (PRES OF CORP) |
| Authorized Official Contact | 8154648850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Performance Dental Care Pc 7230 191st St Tinley Park IL 60487-9378 Ph: (815) 464-8850 | Performance Dental Care Pc 7230 191st St Tinley Park IL 60487-9378 Ph: (815) 464-8850 |
| NPI Number | 1942377908 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942377908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019025070 (Illinois) | Primary |
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