Provider Demographics
NPI:1003942137
Name:TOWN LINE DENTAL CARE
Entity Type:Organization
Organization Name:TOWN LINE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KATS
Authorized Official - Suffix:
Authorized Official - Credentials:D D S
Authorized Official - Phone:847-566-8585
Mailing Address - Street 1:362 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4225
Mailing Address - Country:US
Mailing Address - Phone:847-566-8585
Mailing Address - Fax:847-566-6819
Practice Address - Street 1:362 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4225
Practice Address - Country:US
Practice Address - Phone:847-566-8585
Practice Address - Fax:847-566-6819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty