Organization
ILLINOIS DENTAL PROVIDERS (TINLEY PARK), 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
15909 HARLEM AVE, TINLEY PARK, IL 60477-1609
(708) 429-0915
(216) 584-1061
Mailing address
7160 DALLAS PKWY STE 400, PLANO, TX 75024-7111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/27/2006
Last updated
02/05/2018
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