Provider Demographics
NPI:1053833673
Name:DAC DENTAL PC
Entity Type:Organization
Organization Name:DAC DENTAL PC
Other - Org Name:ROLLINS FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CANTY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-546-2900
Mailing Address - Street 1:305 E ROLLINS RD
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-1331
Mailing Address - Country:US
Mailing Address - Phone:847-546-2900
Mailing Address - Fax:847-546-2909
Practice Address - Street 1:305 E ROLLINS RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-1331
Practice Address - Country:US
Practice Address - Phone:847-546-2900
Practice Address - Fax:547-546-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty