My Geriatric Dentist
NPI #1366064594 in Des Plaines, Illinois
Provider Information
- NPI Number
- 1366064594
- Entity Type
- Organization
- Organization Name
- My Geriatric Dentist
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 11, 2020
- Last Updated
- May 11, 2020
Practice Location
- Address
- 2093 RAND RD
- City
- Des Plaines
- State
- Illinois
- ZIP Code
- 60016-4727
- Phone
- (847) 590-1880
Authorized Official
- Name
- MRS. LISA BLUMOFE, DDS
- Title
- DENTIST
- Phone
- (847) 590-1880
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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