PROFESSIONAL DENTAL ALLIANCE OF GROVE DENTAL LLC

BOLINGBROOK, IL
NPI1417583592
Doing Business AsGROVE DENTAL
Entity TypeOrganization
Authorized ContactAMANDA KURTZ
Credentialing Specialist
724-698-2058
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2020-03-20
Last Update Date2021-04-29
Business Address
PROFESSIONAL DENTAL ALLIANCE OF GROVE DENTAL LLC
160 E BOUGHTON RD
BOLINGBROOK, IL 60440-2014
Phone number: 630-759-8940
Mailing Address
PROFESSIONAL DENTAL ALLIANCE OF GROVE DENTAL LLC
PO BOX 715279
CINCINNATI, OH 45271-5279
Phone number: