Provider Demographics
NPI:1215212675
Name:DENTAL CARE OF OAKBROOK, P.C
Entity Type:Organization
Organization Name:DENTAL CARE OF OAKBROOK, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMET
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-833-2800
Mailing Address - Street 1:17W300 22ND ST
Mailing Address - Street 2:SUITE 350
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4405
Mailing Address - Country:US
Mailing Address - Phone:630-833-2800
Mailing Address - Fax:
Practice Address - Street 1:17W300 22ND ST
Practice Address - Street 2:SUITE 350
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4405
Practice Address - Country:US
Practice Address - Phone:630-833-2800
Practice Address - Fax:630-833-2821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty