Deer Park Dental Ltd

NPI #1700101326 in Deer Park, Illinois

Provider Information

NPI Number: 1700101326
Entity Type: Organization
Organization Name: Deer Park Dental Ltd
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 7, 2010
Last Updated: Apr 7, 2010

Practice Location

Address: 21660 W. FIELD PARKWAY
City: Deer Park
State: Illinois
ZIP Code: 60010
Phone: (847) 438-9669

Authorized Official

Name: BRUCE PRIVATSKY
Title: OWNER
Phone: (847) 438-9669

Specialties & Taxonomy Codes

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

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