Healthcare Provider Details

I. General information

NPI: 1801035092
Provider Name (Legal Business Name): DON C. KALANT SR., D.D.S. AND ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2009
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 MACOM DR
NAPERVILLE IL
60564-3202
US

IV. Provider business mailing address

1303 MACOM DR
NAPERVILLE IL
60564-3202
US

V. Phone/Fax

Practice location:
  • Phone: 630-851-9100
  • Fax: 630-851-6983
Mailing address:
  • Phone: 630-851-9100
  • Fax: 630-851-6983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number019026465
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number021.001314
License Number StateIL

VIII. Authorized Official

Name: DR. DON C KALANT SR.
Title or Position: OWNER/ PRESIDENT
Credential: D.D.S.
Phone: 630-851-9100