Organization
DRS. PEARLMAN, KLENETSKY & SIMCOX ORAL & MAXILLOFACIAL SURGERY, LTD.
Active
Other names
DRS. PEARLMAN, KLENETSKY & SIMCOX ORAL & MAXILLOFACIAL SURGERY, LTD.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLAN D. KLENETSKY D.M.D. (PRESIDENT)
(708) 383-8851
Entity
Organization
Contact information
Practice address
1126 WESTGATE ST, OAK PARK, IL 60301-1008
(708) 383-8851
(708) 383-6272
Mailing address
1126 WESTGATE ST, OAK PARK, IL 60301-1008
(708) 383-8851
(708) 383-6272
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21000970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215932
PTAN
IL
Enumeration date
02/05/2007
Last updated
04/01/2015
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