| Southwest Dental Group | |
|
16600 107th St Orland Park IL 60467-8898 | |
| (708) 403-3355 | |
| Not Available |
| Full Name | Southwest Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16600 107th St, Orland Park, Illinois |
| Authorized Official Name and Position | Robert L Tentler (OWNER) |
| Authorized Official Contact | 7084033355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Dental Group 16600 107th St Orland Park IL 60467-8898 Ph: (708) 403-3355 | Southwest Dental Group 16600 107th St Orland Park IL 60467-8898 Ph: (708) 403-3355 |
| NPI Number | 1306090170 |
|---|---|
| Provider Enumeration Date | 11/06/2008 |
| Last Update Date | 11/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306090170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019021002 (Illinois) | Primary |
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