Performace Dental Care Il Pc

LBN: Performace Dental Care Il Pc
Performace Dental Care Il Pc is an health care organization with primary practice located at 7230 191St St , Tinley Park IL 60487-9378. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Performace Dental Care Il Pc can be contacted via phone (815) 464-8850, or through Fatland, Kevin Fatland via phone (815) 464-8850.

Contact Information

Primary practice address
7230 191St St Tinley Park IL 60487-9378
Phone: (815) 464-8850
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Fatland, Kevin Fatland
Phone: (815) 464-8850

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 19025070 Illinois

Profile Details

NPI number 1447670054
LBN Legal business name Performace Dental Care Il Pc
DBA Doing business as
Authorized official Fatland, Kevin Fatland
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2014
Last updated Apr 22nd, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447670054 NPPES
Illinois MEDICAID 01902570

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