Organization
ILLINOIS DENTAL PROVIDERS (HARLEM & NORTH), LTD.
Active
Parent organization
DENTALONE PARTNERS, INC
Other names
DentalWorks of Forest Park
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTALONE PARTNERS, INC
Authorized official
RACHEL NITTINGER (MANAGER CREDENTIALING)
(972) 755-0816
Entity
Organization
Contact information
Practice address
7235 MADISON ST, FOREST PARK, IL 60130-1764
(708) 405-9344
(216) 584-1016
Mailing address
7160 DALLAS PKWY STE 400, PLANO, TX 75024-7111
(972) 755-0816
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
019.022557
IL
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/11/2006
Last updated
02/08/2018
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