Provider Demographics
NPI:1376740316
Name:PATRICK A SPILOTRO DDS PC
Entity Type:Organization
Organization Name:PATRICK A SPILOTRO DDS PC
Other - Org Name:SPILOTRO DENTAL ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPILOTRO
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-299-0557
Mailing Address - Street 1:2604 E DEMPSTER ST
Mailing Address - Street 2:LANDINGS PROFESSIONAL CENTER SUITE 202
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-299-0557
Mailing Address - Fax:547-299-0561
Practice Address - Street 1:2604 E DEMPSTER ST
Practice Address - Street 2:LANDINGS PROFESSIONAL CENTER SUITE 202
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-299-0557
Practice Address - Fax:547-299-0561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center