Performace Dental Care Il PC

NPI #1497175988 in Flossmoor, Illinois

Provider Information

NPI Number: 1497175988
Entity Type: Organization
Organization Name: Performace Dental Care Il PC
Primary Specialty: Dentist
Enumeration Date: Apr 23, 2014
Last Updated: Apr 23, 2014

Practice Location

Address: 19509 GOVERNORS HWY
City: Flossmoor
State: Illinois
ZIP Code: 60422-2097
Phone: (708) 647-7509

Authorized Official

Name: KEVIN FATLAND
Title: DENTIST
Phone: (708) 647-7509

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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