Provider Demographics
NPI:1164694261
Name:BEATA CZECHURA D.M.D., P.C.
Entity Type:Organization
Organization Name:BEATA CZECHURA D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEATA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CZECHURA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PC
Authorized Official - Phone:847-359-3336
Mailing Address - Street 1:504 N PLUM GROVE RD STE A
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8207
Mailing Address - Country:US
Mailing Address - Phone:847-359-3336
Mailing Address - Fax:847-359-3377
Practice Address - Street 1:504 N PLUM GROVE RD STE A
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8207
Practice Address - Country:US
Practice Address - Phone:847-359-3336
Practice Address - Fax:847-359-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190271441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty