Provider Demographics
NPI:1457374415
Name:GEORGE F DEIHS III DDS PC
Entity Type:Organization
Organization Name:GEORGE F DEIHS III DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEIHS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-426-5030
Mailing Address - Street 1:602 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-2026
Mailing Address - Country:US
Mailing Address - Phone:847-426-5030
Mailing Address - Fax:847-426-1554
Practice Address - Street 1:602 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-2026
Practice Address - Country:US
Practice Address - Phone:847-426-5030
Practice Address - Fax:847-426-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-18876261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental