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General NPI Number Information
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NPI Number | 1073379160
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Entity Type | Organization
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Legal Business Name | PETER M. DURBIN, D.D.S., M.S., P.C.
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 1355 E GOLF RD
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City | DES PLAINES
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State | IL
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Zip | 60016-1544
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Country | US
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Telephone | 847-824-0154
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Fax |
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Provider Business Mailing Address
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Address Line | 1355 E GOLF RD
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City | DES PLAINES
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State | IL
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Zip | 60016-1544
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Country | US
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Telephone | 847-824-0154
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETER DURBIN
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Credential | DDS, MS
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Telephone | 847-824-0154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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