Provider Demographics
NPI:1184003667
Name:TEKDOGAN DENTAL HEALTH CENTERS, LLC
Entity Type:Organization
Organization Name:TEKDOGAN DENTAL HEALTH CENTERS, LLC
Other - Org Name:GREAT SMILE DENTISTRY DEERFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:TEKDOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-917-8251
Mailing Address - Street 1:720 OSTERMAN AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4471
Mailing Address - Country:US
Mailing Address - Phone:847-945-1050
Mailing Address - Fax:847-940-0433
Practice Address - Street 1:720 OSTERMAN AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4471
Practice Address - Country:US
Practice Address - Phone:847-945-1050
Practice Address - Fax:847-940-0433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty