Green Bay Trail Dentistry

NPI #1457405987 in Evanston, Illinois

Provider Information

NPI Number: 1457405987
Entity Type: Organization
Organization Name: Green Bay Trail Dentistry
Primary Specialty: Dentist
Enumeration Date: Jan 22, 2007
Last Updated: May 24, 2011

Practice Location

Address: 2632 GREEN BAY RD
City: Evanston
State: Illinois
ZIP Code: 60201
Phone: (847) 869-4844

Authorized Official

Name: ERIC ESTES, DDS
Title: OWNER PROVIDER
Phone: (847) 869-4844

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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