Dental On 45 INC

NPI #1497165385 in Third Lake, Illinois

Provider Information

NPI Number: 1497165385
Entity Type: Organization
Organization Name: Dental On 45 INC
Primary Specialty: Dentist - General Practice
Enumeration Date: May 1, 2014
Last Updated: May 1, 2014

Practice Location

Address: 34484 N US HIGHWAY 45
Address 2: SUITE C
City: Third Lake
State: Illinois
ZIP Code: 60030-4038
Phone: (224) 541-4066

Authorized Official

Name: DR. NATALIYA KORNIYCHUK, DMD
Title: VICE-PRESIDENT
Phone: (224) 616-9264

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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