Glen Ellyn Orthodontics, PC
NPI #1063954477 in Glen Ellyn, Illinois
Provider Information
- NPI Number
- 1063954477
- Entity Type
- Organization
- Organization Name
- Glen Ellyn Orthodontics, PC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Nov 16, 2016
- Last Updated
- Nov 16, 2016
Practice Location
- Address
- 45 S PARK BLVD
- Address 2
- SUITE 220
- City
- Glen Ellyn
- State
- Illinois
- ZIP Code
- 60137-6280
- Phone
- (630) 469-6200
Authorized Official
- Name
- DR. BRUCE S. WARDELL, DMD
- Title
- PRESIDENT
- Phone
- (630) 697-0334
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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