Provider Demographics
NPI:1639187834
Name:KASPER,HEATON,WRIGHT,PAGNI,ANDASSOCIATES,LTD
Entity Type:Organization
Organization Name:KASPER,HEATON,WRIGHT,PAGNI,ANDASSOCIATES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KASPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-423-5990
Mailing Address - Street 1:13161 W 143RD ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-6890
Mailing Address - Country:US
Mailing Address - Phone:708-301-1930
Mailing Address - Fax:708-301-1939
Practice Address - Street 1:13161 W 143RD ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-6890
Practice Address - Country:US
Practice Address - Phone:708-301-1930
Practice Address - Fax:708-301-1939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty