PROFESSIONAL DENTAL ALLIANCE OF GROVE DENTAL SPECIALTY LLC

BOLINGBROOK, IL
NPI1215563762
Doing Business AsGROVE DENTAL
Entity TypeOrganization
Authorized ContactAMANDA KURTZ
Credentialing Specialist
724-698-2058
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2020-03-17
Last Update Date2021-04-28
Business Address
PROFESSIONAL DENTAL ALLIANCE OF GROVE DENTAL SPECIALTY LLC
160 E BOUGHTON RD
BOLINGBROOK, IL 60440-2014
Phone number: 630-410-1766
Mailing Address
PROFESSIONAL DENTAL ALLIANCE OF GROVE DENTAL SPECIALTY LLC
PO BOX 715279
CINCINNATI, OH 45271-5279
Phone number: