Glen Ellyn Family Dental Care

NPI #1487731808 in Glen Ellyn, Illinois

Provider Information

NPI Number: 1487731808
Entity Type: Organization
Organization Name: Glen Ellyn Family Dental Care
Primary Specialty: Dentist
Enumeration Date: Nov 1, 2006
Last Updated: Feb 15, 2012

Practice Location

Address: 658 ROOSEVELT RD
City: Glen Ellyn
State: Illinois
ZIP Code: 60137
Phone: (630) 858-0216

Authorized Official

Name: MRS. DEBBIE A SANSONE
Title: OFFICE MANAGER
Phone: (630) 858-0216

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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