Organization
THE DENTAL SPECIALISTS INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA PROKOP (CFO)
(630) 556-2062
Entity
Organization
Contact information
Practice address
10012 CALUMET AVE STE B, MUNSTER, IN 46321-4055
(630) 556-2062
Mailing address
17W110 22ND ST STE 150, OAKBROOK TERRACE, IL 60181-4454
(630) 556-2062
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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