Provider Demographics
NPI:1992850697
Name:GARTNER ORTHODONTICS, LTD.
Entity Type:Organization
Organization Name:GARTNER ORTHODONTICS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GARTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-823-3141
Mailing Address - Street 1:101 S WASHINGTON AVE
Mailing Address - Street 2:#105
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S WASHINGTON AVE
Practice Address - Street 2:#105
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4200
Practice Address - Country:US
Practice Address - Phone:847-823-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty