Provider Demographics
NPI:1225494107
Name:KENNETH P. TRCH, DDS, P.C.
Entity Type:Organization
Organization Name:KENNETH P. TRCH, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:TRCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-232-0895
Mailing Address - Street 1:127 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4516
Mailing Address - Country:US
Mailing Address - Phone:630-232-0895
Mailing Address - Fax:630-232-0051
Practice Address - Street 1:127 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4516
Practice Address - Country:US
Practice Address - Phone:630-232-0895
Practice Address - Fax:630-232-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026990122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty