Organization
WALTER TATCH, D.D.S., LTD.
Active
Other names
CENTER FOR ORAL AND FACIAL SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANA MANDEL-TATCH (OFFICE MANAGER)
(972) 898-5336
Entity
Organization
Contact information
Practice address
310 S GREENLEAF ST STE 203, GURNEE, IL 60031-5708
(847) 623-5915
(847) 623-1174
Mailing address
310 S GREENLEAF ST STE 203, GURNEE, IL 60031-5708
(847) 623-5915
(847) 623-1174
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021002076
IL
Other
Enumeration date
10/20/2006
Last updated
08/14/2013
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