| Suburban Periodontal Associates Limited | |
|
120 Oakbrook Center Suite 600 Oak Brook IL 60523 | |
| (630) 368-0605 | |
| (630) 368-9616 |
| Full Name | Suburban Periodontal Associates Limited |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 120 Oakbrook Center, Oak Brook, Illinois |
| Authorized Official Name and Position | Gina D Gruendeman (PRESIDENT) |
| Authorized Official Contact | 6303680605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Periodontal Associates Limited 120 Oakbrook Center Suite 600 Oak Brook IL 60523 Ph: (630) 368-0605 | Suburban Periodontal Associates Limited 120 Oakbrook Center Suite 600 Oak Brook IL 60523 Ph: (630) 368-0605 |
| NPI Number | 1578680765 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 11/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578680765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 021601479 (Illinois) | Primary |
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