WALTER TATCH D.D.S. LTD. NPI 1356423891

NPI Information

  • NPI: 1356423891
  • Provider Name: WALTER TATCH, D.D.S., LTD.
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Doing Business As: CENTER FOR ORAL AND FACIAL SURGERY
  • Address: 310 S GREENLEAF ST STE 203
    GURNEE, IL
    ZIP 60031
  • Phone: (847) 623-5915

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NPI Details

WALTER TATCH, D.D.S., LTD. is an oral and maxillofacial surgery dentist in Gurnee, IL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. WALTER TATCH, D.D.S., LTD. NPI is 1356423891. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Center For Oral And Facial Surgery.

The provider's business location address is:

310 S GREENLEAF ST STE 203
GURNEE, IL
ZIP 60031-708
Phone: (847) 623-5915
Fax: (847) 623-1174

The provider's authorized official is Diana Mandel-tatch .
The authorized official title is Office Manager and has the following contact phone number (972) 898-5336.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 8/14/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery021002076ILLINOISYes

What is NPI?

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This page was last updated on: 3/30/2025

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