| Southwest Family Dental | |
|
165 S Marley Rd New Lenox IL 60451-6045 | |
| (815) 485-3449 | |
| Not Available |
| Full Name | Southwest Family Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 165 S Marley Rd, New Lenox, Illinois |
| Authorized Official Name and Position | Brendan D Mcgraw (OWNER) |
| Authorized Official Contact | 8154853449 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Family Dental 165 S Marley Rd New Lenox IL 60451-3302 Ph: (815) 485-3449 | Southwest Family Dental 165 S Marley Rd New Lenox IL 60451-6045 Ph: (815) 485-3449 |
| NPI Number | 1982186896 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 09/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982186896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019029805 (Illinois) | Primary |
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