Fox Valley Dental Associates of Crystal Lake LLC
NPI #1972646925 in Crystal Lake, Illinois
Provider Information
- NPI Number
- 1972646925
- Entity Type
- Organization
- Organization Name
- Fox Valley Dental Associates of Crystal Lake LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 15, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 360 N TERRA COTTA RD
- Address 2
- SUITE #D
- City
- Crystal Lake
- State
- Illinois
- ZIP Code
- 60012-3749
- Phone
- (815) 477-0770
Authorized Official
- Name
- DR. GREGG R HORNYAK, D.D.S.
- Title
- GENERAL DENTIST MANAGING MEMBER
- Phone
- (815) 477-0770
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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