Provider Demographics
NPI:1194264903
Name:INTEGRAL ORTHODONTICS, LTD
Entity type:Organization
Organization Name:INTEGRAL ORTHODONTICS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARBOLEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-907-4492
Mailing Address - Street 1:379 N SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-2322
Mailing Address - Country:US
Mailing Address - Phone:847-970-3000
Mailing Address - Fax:
Practice Address - Street 1:379 N SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-2322
Practice Address - Country:US
Practice Address - Phone:847-970-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty