Provider Demographics
NPI:1609200609
Name:PINNACLE DENTAL CENTERS LLC
Entity Type:Organization
Organization Name:PINNACLE DENTAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:DOOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-602-5068
Mailing Address - Street 1:527 S BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-1309
Mailing Address - Country:US
Mailing Address - Phone:630-289-5727
Mailing Address - Fax:
Practice Address - Street 1:527 S BARTLETT RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1309
Practice Address - Country:US
Practice Address - Phone:630-289-5727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL248.000858261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental