Provider Demographics
NPI:1194280941
Name:KENNETH J. SZAFRANSKI, DDS, LTD MATTHEW S. VAN BEEK, DDS
Entity type:Organization
Organization Name:KENNETH J. SZAFRANSKI, DDS, LTD MATTHEW S. VAN BEEK, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SZAFRANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-246-4333
Mailing Address - Street 1:1100 HILLGROVE AVE
Mailing Address - Street 2:SUITE 1&2
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558
Mailing Address - Country:US
Mailing Address - Phone:708-246-4333
Mailing Address - Fax:708-246-4356
Practice Address - Street 1:1100 HILLGROVE AVE
Practice Address - Street 2:SUITE 1&2
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558
Practice Address - Country:US
Practice Address - Phone:708-246-4333
Practice Address - Fax:708-246-4356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty