Provider Demographics
NPI:1013098508
Name:AFO DENTAL GROUP, LTD
Entity Type:Organization
Organization Name:AFO DENTAL GROUP, LTD
Other - Org Name:BAYHILL DENTAL, LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VIHNANEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-669-6400
Mailing Address - Street 1:12171 REGENCY SQUARE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142
Mailing Address - Country:US
Mailing Address - Phone:847-669-6400
Mailing Address - Fax:847-669-6885
Practice Address - Street 1:12171 REGENCY SQUARE PARKWAY
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142
Practice Address - Country:US
Practice Address - Phone:847-669-6400
Practice Address - Fax:847-669-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 122300000X, 124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Single Specialty
Not Answered124Q00000XDental ProvidersDental HygienistGroup - Single Specialty