Provider Demographics
NPI:1528127537
Name:THIRTY NORTH ENDODONTICS LTD
Entity type:Organization
Organization Name:THIRTY NORTH ENDODONTICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-236-6077
Mailing Address - Street 1:30 N MICHIGAN AVENUE #1320
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602
Mailing Address - Country:US
Mailing Address - Phone:312-236-6077
Mailing Address - Fax:312-236-7985
Practice Address - Street 1:30 N MICHIGAN AVENUE #1320
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602
Practice Address - Country:US
Practice Address - Phone:312-236-6077
Practice Address - Fax:312-236-7985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty