Glen Ellyn Pediatric Dentistry ,p.c..
NPI #1043390792 in Glen Ellyn, Illinois
Provider Information
- NPI Number
- 1043390792
- Entity Type
- Organization
- Organization Name
- Glen Ellyn Pediatric Dentistry ,p.c..
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Oct 17, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 45 S PARK BLVD
- Address 2
- SUITE #105
- City
- Glen Ellyn
- State
- Illinois
- ZIP Code
- 60137-6280
- Phone
- (630) 858-8755
Authorized Official
- Name
- MRS. MARTHA A LAMBERT, R.D., M.P.H.
- Title
- CORP SECRETARY/TREASURER, MANAGER
- Phone
- (630) 858-8755
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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