Provider Demographics
NPI:1225221898
Name:D.C. DENTAL, LTD
Entity Type:Organization
Organization Name:D.C. DENTAL, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANDOK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-289-9900
Mailing Address - Street 1:840 SUMMIT ST STE K
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-4300
Mailing Address - Country:US
Mailing Address - Phone:847-289-9900
Mailing Address - Fax:
Practice Address - Street 1:840 SUMMIT ST STE K
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4300
Practice Address - Country:US
Practice Address - Phone:847-289-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty