Healthcare Provider Details

I. General information

NPI: 1598823874
Provider Name (Legal Business Name): BARTZ & BARTZ DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8704 S RIDGELAND AVE
OAKLAWN IL
60453-1068
US

IV. Provider business mailing address

8704 S RIDGELAND AVE
OAKLAWN IL
60453-1068
US

V. Phone/Fax

Practice location:
  • Phone: 708-430-4440
  • Fax: 708-430-4528
Mailing address:
  • Phone: 708-430-4440
  • Fax: 708-430-4528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number19014517
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. DENIS JOSEPH BARTZ
Title or Position: DDS CO OWNER
Credential:
Phone: 708-430-4440