Provider Demographics
NPI:1679738603
Name:RANDHURST DENTAL P.C.
Entity Type:Organization
Organization Name:RANDHURST DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERROL
Authorized Official - Middle Name:S
Authorized Official - Last Name:OZTEKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-818-1118
Mailing Address - Street 1:301 E RAND RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6089
Mailing Address - Country:US
Mailing Address - Phone:847-818-1118
Mailing Address - Fax:847-818-8111
Practice Address - Street 1:301 E RAND RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6089
Practice Address - Country:US
Practice Address - Phone:847-818-1118
Practice Address - Fax:847-818-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty