Provider Demographics
NPI:1871180174
Name:PALATINE DENTAL
Entity Type:Organization
Organization Name:PALATINE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUBRAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-359-8732
Mailing Address - Street 1:232 E NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8107
Mailing Address - Country:US
Mailing Address - Phone:847-359-8732
Mailing Address - Fax:
Practice Address - Street 1:232 E NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8107
Practice Address - Country:US
Practice Address - Phone:847-359-8732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty