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Organization
THOMAS L. PRENDERGAST, DDS, PC
Active
Organization
THOMAS L. PRENDERGAST, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS L. PRENDERGAST DDS (PRESIDENT)
(847) 587-5053
Entity
Organization
Contact information
Practice address
1394 S ROUTE 12, FOX LAKE, IL 60020-1949
(847) 587-5053
Mailing address
1394 S ROUTE 12, FOX LAKE, IL 60020-1949
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-022387
IL
Other
Enumeration date
05/09/2012
Last updated
05/09/2012
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