Provider Demographics
NPI:1508937285
Name:DR. TREFIL AND DR. LAROCCA PC
Entity Type:Organization
Organization Name:DR. TREFIL AND DR. LAROCCA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TREFIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-349-6607
Mailing Address - Street 1:14600 JOHN HUMPHREY DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2642
Mailing Address - Country:US
Mailing Address - Phone:708-349-6607
Mailing Address - Fax:
Practice Address - Street 1:14600 JOHN HUMPHREY DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2642
Practice Address - Country:US
Practice Address - Phone:708-349-6607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty