Provider Demographics
NPI:1972682151
Name:APPLE DENTAL ASSOCIATES LTD
Entity type:Organization
Organization Name:APPLE DENTAL ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:O'CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:847-296-8111
Mailing Address - Street 1:712 LEE ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4515
Mailing Address - Country:US
Mailing Address - Phone:847-296-8111
Mailing Address - Fax:847-296-8113
Practice Address - Street 1:712 LEE ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4515
Practice Address - Country:US
Practice Address - Phone:847-296-8111
Practice Address - Fax:847-296-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019198991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty