Crystal Lake Family Dental

NPI 1154761492 - Dentist - 1223G0001X

NPI Details
NPI 1154761492
Enumeration Date 07/01/2013
Last Updated 07/01/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name ALAN J ALAN
Position OWNER
Phone (630) 339-3172
Fax (847) 891-6775
Practice Location
651 W TERRA COTTA AVE
SUITE 201
CRYSTAL LAKE IL, 60014-3404, US
Phone (630) 339-3172
Fax (847) 891-6775
Business Location
129 S ROSELLE RD
SUITE 102
SCHAUMBURG IL, 60193-5540, US
Phone (630) 339-3172
Fax (847) 891-6775
Toxanomy
Taxonomy Code 1223G0001X
License State
License Number
Remove 1154761492 NPI Number
 

According to our database, Crystal Lake Family Dental NPI is 1154761492, taxonomy code is 1223G0001X Crystal Lake Family Dental physically located at 651 W Terra Cotta Ave, Crystal Lake IL, 60014-3404. NPI Number 1033115704 has the healthcare provider type.

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1154761492 NPI number is provided on an as is basis without warranty of any kind. 1154761492 is maintained by the National Plan & Provider Enumeration System. The contents of Crystal Lake Family Dental are for informational purposes only.