Organization
FOX VALLEY DENTAL ASSOCIATES OF CRYSTAL LAKE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGG R HORNYAK D.D.S. (GENERAL DENTIST MANAGING MEMBER)
(815) 477-0770
Entity
Organization
Contact information
Practice address
360 N TERRA COTTA RD, SUITE #D, CRYSTAL LAKE, IL 60012-3749
(815) 477-0770
(815) 444-8841
Mailing address
360 N TERRA COTTA RD, SUITE #D, CRYSTAL LAKE, IL 60012-3749
(815) 477-0770
(815) 444-8841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
02/15/2007
Last updated
08/22/2020
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