Provider Demographics
NPI:1801941828
Name:CRATIN, THOMAS L (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:CRATIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 CHESTNUT ST
Mailing Address - Street 2:SUITE 1 C
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3171
Mailing Address - Country:US
Mailing Address - Phone:630-655-3522
Mailing Address - Fax:630-655-3681
Practice Address - Street 1:522 CHESTNUT ST
Practice Address - Street 2:SUITE 1 C
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3171
Practice Address - Country:US
Practice Address - Phone:630-655-3522
Practice Address - Fax:630-655-3681
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190162851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice