Provider Demographics
NPI:1952654089
Name:EZ DENTAL CARE
Entity type:Organization
Organization Name:EZ DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAYED HAROON
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:630-376-6369
Mailing Address - Street 1:17W697 BUTTERFIELD RD.
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-376-6369
Mailing Address - Fax:630-485-6939
Practice Address - Street 1:17W697 BUTTERFIELD RD
Practice Address - Street 2:SUITE A
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4042
Practice Address - Country:US
Practice Address - Phone:630-376-6369
Practice Address - Fax:630-485-6939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0257041223G0001X
IL019-0261521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty