Organization
ILLINOIS DENTAL PROVIDERS (GLEN ELLYN), LTD
Active
Parent organization
DENTALONE PARTNERS, INC.
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
701 ROOSEVELT RD, GLEN ELLYN, IL 60137-5805
(630) 790-8430
(216) 584-1056
Mailing address
7160 DALLAS PKWY STE 400, PLANO, TX 75024-7111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/16/2015
Last updated
03/20/2018
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