| NPI | 1558145227 |
|---|---|
| Doing Business As | ASSOCIATED DENTAL SPECIALISTS OF LONG GROVE |
| Entity Type | Organization |
| Authorized Contact | ERICA QUINTEROS Credentialing 724-901-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-12-13 |