Sugar Grove Dental Associates,pc
NPI #1972848935 in Sugar Grove, Illinois
Provider Information
- NPI Number
- 1972848935
- Entity Type
- Organization
- Organization Name
- Sugar Grove Dental Associates,pc
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Dec 3, 2012
- Last Updated
- Dec 3, 2012
Practice Location
- Address
- 495 N STATE ROUTE 47
- Address 2
- SUITE J
- City
- Sugar Grove
- State
- Illinois
- ZIP Code
- 60554-8009
- Phone
- (630) 466-1100
Authorized Official
- Name
- DR. GLENN LOUIS DEWEIRDT, DDS
- Title
- PRESIDENT
- Phone
- (630) 466-1100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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