Organization
LTC DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA ROBINSON (CEO)
(407) 375-3003
Entity
Organization
Contact information
Practice address
3500 W PETERSON AVE STE 401, CHICAGO, IL 60659-3307
(407) 375-3003
Mailing address
3500 W PETERSON AVE STE 401, CHICAGO, IL 60659-3307
(407) 375-3003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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