Provider Demographics
NPI:1326245705
Name:DENTAL HEALTH CARE LTD
Entity Type:Organization
Organization Name:DENTAL HEALTH CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MARINIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-475-8700
Mailing Address - Street 1:2611 BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1501
Mailing Address - Country:US
Mailing Address - Phone:847-475-8700
Mailing Address - Fax:847-475-9964
Practice Address - Street 1:2611 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1501
Practice Address - Country:US
Practice Address - Phone:847-475-8700
Practice Address - Fax:847-475-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty