| Organization Name: | BURLINGTON DENTAL CARE, LLC |
| NPI Number: | 1982889994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENISE LYNN TERESE-KOCH (OWNER/GENERAL DENTIST) |
| Mailing Address: | 235 Burlington Ave Clarendon Hills |
| State: | IL US |
| Postal Code: | 605141148 |
| Phone Number: | 6303259298 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2008 |
| NPI Last Update Date: | 01/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |