Provider Demographics
NPI:1023192952
Name:NAPERVILLE DENTAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:NAPERVILLE DENTAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PETRAUSKAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-369-0101
Mailing Address - Street 1:1220 HOBSON RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8139
Mailing Address - Country:US
Mailing Address - Phone:630-369-0101
Mailing Address - Fax:630-369-1586
Practice Address - Street 1:1220 HOBSON RD
Practice Address - Street 2:SUITE 240
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8139
Practice Address - Country:US
Practice Address - Phone:630-369-0101
Practice Address - Fax:630-369-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty