Town Centre Dental Group, Ltd.
Dentist, General Practice in Evanston, IL. Organization (NPI-2).
NPI number1154530459
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1154530459
- Entity type
- Organization (NPI-2)
- Legal business name
- Town Centre Dental Group, Ltd.
- Organization subpart
- No
- Enumeration date
- May 22, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
636 Church StSuite 309
Evanston, IL 60201-4508
Phone 847-328-1180 · Fax 847-328-1189
Mailing address
636 Church StSuite 309
Evanston, IL 60201-4508
Phone 847-328-1180 · Fax 847-328-1189
Authorized official
Robert S. Krueger
President
8473281180
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