Provider Demographics
NPI:1417014283
Name:ARLINGTON COMFORT DENTAL PARTNERSHIP
Entity type:Organization
Organization Name:ARLINGTON COMFORT DENTAL PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:RELIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-255-4575
Mailing Address - Street 1:271 N DUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5903
Mailing Address - Country:US
Mailing Address - Phone:847-255-4575
Mailing Address - Fax:847-255-4660
Practice Address - Street 1:271 N DUNTON AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5903
Practice Address - Country:US
Practice Address - Phone:847-255-4575
Practice Address - Fax:847-255-4660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty