Glen Flora Dental

NPI #1407161953 in Waukegan, Illinois

Provider Information

NPI Number: 1407161953
Entity Type: Organization
Organization Name: Glen Flora Dental
Primary Specialty: Dentist
Enumeration Date: Aug 9, 2010
Last Updated: Aug 9, 2010

Practice Location

Address: 1020 W GLEN FLORA AVE
Address 2: SUITE 102
City: Waukegan
State: Illinois
ZIP Code: 60085-1882
Phone: (847) 623-0399

Authorized Official

Name: MS. BRANDI M SKINNER
Title: OFFICE MANAGER
Phone: (847) 623-0399

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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