Provider Demographics
NPI:1326451691
Name:WATER TOWER ENDODONTICS, LTD.
Entity Type:Organization
Organization Name:WATER TOWER ENDODONTICS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:REMPAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-763-5890
Mailing Address - Street 1:845 N MICHIGAN AVE
Mailing Address - Street 2:AUITE 921 EAST
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2252
Mailing Address - Country:US
Mailing Address - Phone:312-751-0026
Mailing Address - Fax:312-751-0241
Practice Address - Street 1:845 N MICHIGAN AVE
Practice Address - Street 2:AUITE 921 EAST
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2252
Practice Address - Country:US
Practice Address - Phone:312-751-0026
Practice Address - Fax:312-751-0241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019015631261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental