Dental on 45 Inc
Organization Active NPI General Practice Dentistry · Third Lake, IL
NPI 1497165385 · NPPES record last updated May 1, 2014
Key facts
- NPI
- 1497165385
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- DENTAL ON 45 INC
- Practice address
- 34484 N US Highway 45
Suite C
Third Lake, IL 60030-4038 - Phone
- (224) 541-4066
- Fax
- (847) 752-8425
- NPI assigned
- May 1, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Nataliya Korniychuk, DMD
- Title
- Vice-President
- Phone
- (224) 616-9264
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Dental on 45 Inc
Locations
34484 N US Highway 45
Ste C
Third Lake, IL 60030
Phone (224) 541-4066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
34484 N US Highway 45
Suite C
Third Lake, IL 60030-4038
Mailing address
34484 N US Highway 45
Suite C
Third Lake, IL 60030-4038
Phone (224) 541-4066
Other providers in Third Lake, IL
- Troy Bloom
- Sarah Busby
- Irene Carod
- Julie Crowe-McCarthy
- Dental on 45 Inc
- Vishwa Desai
- Highland Park CVS, L.L.C.
- Laurinia Hunter
- Laura Y Joya
- Nataliya Korniychuk
All providers in Third Lake, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.