Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Crystal Lake Pediatric Dental Ltd

Organization Pediatric Dentistry · NPI 1043311681

Crystal Lake Pediatric Dental Ltd provides Pediatric Dentistry in Crystal Lake, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

820 E Terra Cotta Ave 111
Crystal Lake, IL 60014-3649
Phone: (815) 356-7960
Fax: (815) 356-8051
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X (IL)

Record details

NPI number1043311681
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Anthony Minutillo — President · (815) 356-7960
NPI enumeratedSeptember 26, 2006
Last updated in NPPESAugust 22, 2020
Mailing address820 E Terra Cotta Ave, 111, Crystal Lake, IL 60014-3649

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