| Glenn J Evans Dds Pc | |
|
703 Parkway Dr Wheaton IL 60187-3646 | |
| (630) 362-8674 | |
| Not Available |
| Full Name | Glenn J Evans Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 703 Parkway Dr, Wheaton, Illinois |
| Authorized Official Name and Position | Glenn Evans (DENTIST) |
| Authorized Official Contact | 6303628674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn J Evans Dds Pc 703 Parkway Dr Wheaton IL 60187-3646 Ph: () - | Glenn J Evans Dds Pc 703 Parkway Dr Wheaton IL 60187-3646 Ph: (630) 362-8674 |
| NPI Number | 1831453307 |
|---|---|
| Provider Enumeration Date | 06/29/2012 |
| Last Update Date | 06/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831453307 | NPI | - | NPPES |
| 9177499 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019026423 (Illinois) | Primary |
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