Organization
DEER PARK DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE PRIVATSKY (OWNER)
(847) 438-9669
Entity
Organization
Contact information
Practice address
21660 W. FIELD PARKWAY, DEER PARK, IL 60010
(847) 438-9669
(847) 438-9660
Mailing address
21660 W. FIELD PARKWAY, DEER PARK, IL 60010
(847) 438-9669
(847) 438-9660
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019021596
IL
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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