Healthcare Provider Details

I. General information

NPI: 1881350247
Provider Name (Legal Business Name): HK DENTAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2021
Last Update Date: 11/10/2021
Certification Date: 11/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W MAIN ST
BARRINGTON IL
60010-3011
US

IV. Provider business mailing address

1800 HOLLY LN
MUNSTER IN
46321-3435
US

V. Phone/Fax

Practice location:
  • Phone: 312-339-6758
  • Fax:
Mailing address:
  • Phone: 312-339-6758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: HARRY KUNELIS
Title or Position: OWNER
Credential: DDS
Phone: 312-339-6758