| Denemark Periodontal Specialists, Ltd. | |
|
570 Village Center Dr Suite 202b Burr Ridge IL 60527-4520 | |
| (630) 654-4141 | |
| (630) 654-4242 |
| Full Name | Denemark Periodontal Specialists, Ltd. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 570 Village Center Dr, Burr Ridge, Illinois |
| Authorized Official Name and Position | Paul John Denemark (PRESIDENT/OWNER) |
| Authorized Official Contact | 6306544141 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Denemark Periodontal Specialists, Ltd. 570 Village Center Dr Suite 202b Burr Ridge IL 60527-4520 Ph: (630) 654-4141 | Denemark Periodontal Specialists, Ltd. 570 Village Center Dr Suite 202b Burr Ridge IL 60527-4520 Ph: (630) 654-4141 |
| NPI Number | 1902042534 |
|---|---|
| Provider Enumeration Date | 01/03/2009 |
| Last Update Date | 11/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902042534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 0109022926 (Illinois) | Primary |
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