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General NPI Number Information
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NPI Number | 1114395316
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Entity Type | Organization
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Legal Business Name | THOMAS R POINTNER, LLC
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 74 N ALFRED AVE
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City | ELGIN
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State | IL
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Zip | 60123-5262
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Country | US
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Telephone | 847-695-1300
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Fax | 847-695-8133
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Provider Business Mailing Address
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Address Line | 74 N ALFRED AVE
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City | ELGIN
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State | IL
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Zip | 60123-5262
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Country | US
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Telephone | 847-695-1300
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Fax | 847-695-8133
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS R POINTNER
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Credential | DDS
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Telephone | 847-695-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019029509
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019022965
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License Number State | IL
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