| 5 Star Family Dental | |
|
615 E 162nd St South Holland IL 60473-2329 | |
| (708) 331-1900 | |
| Not Available |
| Full Name | 5 Star Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 615 E 162nd St, South Holland, Illinois |
| Authorized Official Name and Position | Kevin Lloyd Fatland (DENTIST / OWNER) |
| Authorized Official Contact | 7089907869 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 5 Star Family Dental 615 E 162nd St South Holland IL 60473-2329 Ph: (708) 331-1900 | 5 Star Family Dental 615 E 162nd St South Holland IL 60473-2329 Ph: (708) 331-1900 |
| NPI Number | 1013462175 |
|---|---|
| Provider Enumeration Date | 08/18/2016 |
| Last Update Date | 02/03/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013462175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019025070 (Illinois) | Primary |
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