| Organization Name: | DENTAL CARE OF ALGONQUIN |
| NPI Number: | 1073897211 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GENE H. SHERMAN (DOCTOR) |
| Mailing Address: | 285 Stonegate Rd Algonquin |
| State: | IL US |
| Postal Code: | 601025614 |
| Phone Number: | 8476583400 |
| Fax Number: | 8476583424 |
| NPI Enumeration Date: | 10/06/2011 |
| NPI Last Update Date: | 10/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 019017893 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |