Provider Demographics
NPI:1235249459
Name:THE DENTISTS PLACE LTD
Entity Type:Organization
Organization Name:THE DENTISTS PLACE LTD
Other - Org Name:REBECCA T REYES-MORROW AND OR RODNEY L MORROW
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA T
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-689-1213
Mailing Address - Street 1:2017 GREENBAY ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064
Mailing Address - Country:US
Mailing Address - Phone:847-689-1213
Mailing Address - Fax:847-689-1969
Practice Address - Street 1:2017 GREENBAY ROAD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064
Practice Address - Country:US
Practice Address - Phone:847-689-1213
Practice Address - Fax:847-689-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty