Organization
PERFORMACE DENTAL CARE IL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN FATLAND (DENTIST)
(708) 599-8400
Entity
Organization
Contact information
Practice address
9957 S ROBERTS RD, PALOS HILLS, IL 60465-1646
(708) 599-8400
Mailing address
9957 S ROBERTS RD, PALOS HILLS, IL 60465-1646
(708) 599-8400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19025070
IL
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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