Provider Demographics
NPI:1467850826
Name:TEAM DENTAL
Entity Type:Organization
Organization Name:TEAM DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BYRON
Authorized Official - Last Name:QUICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-362-6660
Mailing Address - Street 1:107 W ROCKLAND RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-2709
Mailing Address - Country:US
Mailing Address - Phone:847-362-6660
Mailing Address - Fax:
Practice Address - Street 1:107 W ROCKLAND RD
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-2709
Practice Address - Country:US
Practice Address - Phone:847-362-6660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty