Organization
KANKAKEE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN FATLAND DMD (MEMBER)
(708) 990-7869
Entity
Organization
Contact information
Practice address
200 E COURT ST STE 504, KANKAKEE, IL 60901-3847
(815) 932-3613
Mailing address
200 E COURT ST STE 504, KANKAKEE, IL 60901-3847
(815) 932-3613
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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