Healthcare Provider Details

I. General information

NPI: 1184003667
Provider Name (Legal Business Name): TEKDOGAN DENTAL HEALTH CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2015
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 OSTERMAN AVE SUITE 304
DEERFIELD IL
60015-4471
US

IV. Provider business mailing address

720 OSTERMAN AVE SUITE 304
DEERFIELD IL
60015-4471
US

V. Phone/Fax

Practice location:
  • Phone: 847-945-1050
  • Fax: 847-940-0433
Mailing address:
  • Phone: 847-945-1050
  • Fax: 847-940-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALI TEKDOGAN
Title or Position: OWNER
Credential: D.D.S.
Phone: 402-917-8251