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General NPI Number Information
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NPI Number | 1144527391
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Entity Type | Organization
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Legal Business Name | ATLAGIC DENTAL, DDS PC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 133 E OGDEN AVE SUITE 200
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City | HINSDALE
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State | IL
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Zip | 60521-3551
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Country | US
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Telephone | 630-321-9191
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Fax | 630-321-9199
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Provider Business Mailing Address
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Address Line | 133 E OGDEN AVE SUITE 200
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City | HINSDALE
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State | IL
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Zip | 60521-3551
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Country | US
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Telephone | 630-321-9191
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Fax | 630-321-9199
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Authorized Official
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Title or Position | DENTIST
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Name | DR. DANA ATLAGIC
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Credential | DDS
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Telephone | 630-321-9191
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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 | 019027498
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License Number State | IL
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