Provider Demographics
NPI:1184859852
Name:ODED GARGIR DDS PC
Entity Type:Organization
Organization Name:ODED GARGIR DDS PC
Other - Org Name:ALL DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ODED
Authorized Official - Middle Name:
Authorized Official - Last Name:GARGIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-889-9442
Mailing Address - Street 1:3442 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-3102
Mailing Address - Country:US
Mailing Address - Phone:708-889-9442
Mailing Address - Fax:
Practice Address - Street 1:3442 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-3102
Practice Address - Country:US
Practice Address - Phone:708-889-9442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-23
Last Update Date:2009-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019021096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty