Provider Demographics
NPI:1417961848
Name:ARLINGTON HEIGHTS DENTAL GROUP LTD
Entity Type:Organization
Organization Name:ARLINGTON HEIGHTS DENTAL GROUP LTD
Other - Org Name:ARLINGTON HEIGHTS DENTAL GROUP LTD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-253-8501
Mailing Address - Street 1:201 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-6059
Mailing Address - Country:US
Mailing Address - Phone:847-253-8501
Mailing Address - Fax:847-253-8543
Practice Address - Street 1:201 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HTS
Practice Address - State:IL
Practice Address - Zip Code:60004-6059
Practice Address - Country:US
Practice Address - Phone:847-253-8501
Practice Address - Fax:847-253-8543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0173841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty