Provider Demographics
NPI:1245343029
Name:DRS SARSHA WILLIAMS DANDINO & ASSOC LTD
Entity type:Organization
Organization Name:DRS SARSHA WILLIAMS DANDINO & ASSOC LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT DENTIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-336-0700
Mailing Address - Street 1:2504 WASHINGTON ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-4960
Mailing Address - Country:US
Mailing Address - Phone:847-336-0700
Mailing Address - Fax:847-336-5773
Practice Address - Street 1:2504 WASHINGTON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-4960
Practice Address - Country:US
Practice Address - Phone:847-336-0700
Practice Address - Fax:847-336-5773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty