Provider Demographics
NPI:1033915749
Name:GERMAN DENTAL ACQUISITION PC
Entity type:Organization
Organization Name:GERMAN DENTAL ACQUISITION PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YAROSLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-312-7119
Mailing Address - Street 1:1275 E BELVIDERE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-2083
Mailing Address - Country:US
Mailing Address - Phone:847-548-5750
Mailing Address - Fax:847-548-5752
Practice Address - Street 1:1275 E BELVIDERE RD STE 202
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-2083
Practice Address - Country:US
Practice Address - Phone:847-548-5750
Practice Address - Fax:847-548-5752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty