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Organization
SOUTHWEST DENTAL GROUP
Active
Organization
SOUTHWEST DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT L TENTLER II DDS (OWNER)
(708) 403-3355
Entity
Organization
Contact information
Practice address
16600 107TH ST, ORLAND PARK, IL 60467-8898
(708) 403-3355
Mailing address
16600 107TH ST, ORLAND PARK, IL 60467-8898
(708) 403-3355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019021002
IL
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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