Provider Demographics
NPI:1407206238
Name:HY LINE DENTAL
Entity Type:Organization
Organization Name:HY LINE DENTAL
Other - Org Name:HYLINE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUMERA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-717-6191
Mailing Address - Street 1:1301 S ROUTE 59 STE 107
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9014
Mailing Address - Country:US
Mailing Address - Phone:630-723-6333
Mailing Address - Fax:630-723-6125
Practice Address - Street 1:1301 S ROUTE 59 STE 107
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9014
Practice Address - Country:US
Practice Address - Phone:630-723-6333
Practice Address - Fax:630-723-6125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028158122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty