Healthcare Provider Details
I. General information
NPI: 1154496495
Provider Name (Legal Business Name): FRANK R. ORLAND, D.D.S. & CARLA P. ORLAND, D.D.S., LTD.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21 N DELAPLAINE RD
RIVERSIDE IL
60546-2022
US
IV. Provider business mailing address
21 N DELAPLAINE RD
RIVERSIDE IL
60546-2022
US
V. Phone/Fax
- Phone: 708-447-2100
- Fax: 708-447-0654
- Phone: 708-447-2100
- Fax: 708-447-0654
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
FRANK
R.
ORLAND
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 708-447-2100