Provider Demographics
NPI:1043097017
Name:K2 DENTAL CARE, PLLC
Entity type:Organization
Organization Name:K2 DENTAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-301-9401
Mailing Address - Street 1:590 BANKVIEW DR STE A
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1858
Mailing Address - Country:US
Mailing Address - Phone:708-301-9401
Mailing Address - Fax:708-301-8515
Practice Address - Street 1:590 BANKVIEW DR STE A
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1858
Practice Address - Country:US
Practice Address - Phone:708-301-9401
Practice Address - Fax:708-301-8515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty