Organization
TINLEY PARK ORTHODONTIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS PRINCE D.D.S. (OWNER)
(708) 614-9420
Entity
Organization
Contact information
Practice address
15234 S HARLEM AVE, ORLAND PARK, IL 60462-4330
(708) 614-9420
Mailing address
15234 HARLEM, ORLAND PARK, IL 60462
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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